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Surgical Treatment of a Post-traumatic Hepatic Artery Aneurysm

2001; Elsevier BV; Volume: 21; Issue: 1 Linguagem: Inglês

10.1053/ejvs.2000.1205

1532-2165

U. Settmacher, Natascha C. Nüssler, Robert Pfitzmann, Michael Heise, Petra Neuhaus,

Liver Disease and Transplantation

A 57-year-old man was admitted with epigastric pain. The patient, who was working as a bus driver, had been involved in a motor vehicle accident 1 year before. He experienced a blunt abdominal trauma during that accident. Post-traumatic abdominal ultrasound revealed no pathological findings. In contrast, the current CT scan showed a partially perfused cystic tumour of the pancreatic head with a diameter of Fig. 1. Intraoperative aspect of the hepatic artery aneurysm nearly 10 cm. This was initially misdiagnosed as a originating from the common hepatic artery. tumour but close examination of the CT revealed aneurysm. The aneurysm was resected and the vasan aneurysm of the hepatic artery. The aneurysm cular continuity was reconstructed by saphenous vein extended into the hilus of the liver, and involvement interposition, where the left hepatic artery and the of the extrahepatic right and left hepatic artery was segment IV-artery were connected to the saphenous suspected. Dulexsonography and angiography failed vein graft in an end-to-side fashion, and an end-toto detect extrahepatic vessels distal to the aneurysm end anastomosis was performed between the right suitable for resconstruction. hepatic artery and the vein (Fig. 2). Within apAt laparotomy the aneurysm was found to arise poximately 50 min the vascular reconstruction was appoximately 2 cm distal from the origin of the comcompleted. The postoperative course was uneventful. mon hepatic artery (Fig. 1). The proper hepatic artery Histology of the resected aneurysm showed no signs was completely involved in the aneurysm. A left and of arteriosclerosis. right hepatic artery as well as a separate artery for the hepatic segment IV could be identified distal of the Discussion