Post traumatic hepatic artery pseudoaneurysm

Case contributed by Dr Domenico Nicoletti

Presentation

Bleeding gastric ulcer treated with endoclip. History of liver trauma 2 years prior.

Patient Data

Age: 70 years
Gender: Female

Saccular pseudoaneurysm with partial thrombosis of the proximal right hepatic artery (diameter 4.5 cm approximately).

Cavernoma in segment 8 of the liver.

CT

Initial trauma CT 2 years earlier

Hepatic lacerations (segments 6 and 7) with haemoperitoneum.

In the arterial phase, there is a perfusion defect in the right lobe of the liver with flow interruption in the right branch of the hepatic artery which is surrounded by a haematoma.

Cavernoma in segment 8 of the liver.

Case Discussion

Hepatic artery aneurysms are rare. Rarer are those associated with a venous or biliary fistula. They tend to be saccular and multiple. Causes include infection, arteriosclerosis, trauma and vasculitis. Untreated aneurysms can lead to rupture into the common bile duct, peritoneum, or nearby hollow viscera.

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Case information

rID: 58684
Published: 1st Mar 2018
Last edited: 10th May 2018
Inclusion in quiz mode: Included

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