Upper gastrointestinal bleeding due to hepatic artery aneurysm: Case report and literature review

• Published in: International journal of surgery case reports Vol. 74; pp. 230 - 233
• Main Authors: Alonso-Lamberti Rizo, Laura, Bustamante Recuenco, Carlos, Cuesta Pérez, Julián, Ramos Rodríguez, José Luis, Salazar Carrasco, Andrea, Valle Rubio, Ainhoa, Jiménez Carneros, Virginia, Jiménez Miramón, Francisco Javier, Jover Navalón, José María
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-01-2020; Elsevier
• Subjects: Case Report; Embolization; Hepatic aneurysm; Hepatic artery; Upper gastrointestinal bleeding; Hepatic artery; Upper gastrointestinal bleeding; Embolization; Hepatic aneurysm
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.08.045

•Hepatic artery aneurysm is an uncommon and asymptomatic disease, but in case of complication requires an urgent treatment.•Symptomatic hepatic artery aneurysms and larger than 2 cm are indications for intervention.•CT angiogram is the recommended technique for the diagnosis of this pathology.•Percoutaneous embolization is an effective alternative in cases that implies large comorbidities and has become very popular.
Aneurysm of the hepatic artery is most of the time a rare and asymptomatic pathology, but in case of complication it shows high morbidity and mortality requiring in many cases an urgent treatment.
A 92-year-old male presented at the emergency department with high gastrointestinal bleeding and abdominal pain. Gastroscopy showed a submucosal lesion with active bleeding that was controlled through this approach. The study was expanded with a CT angiogram and a complicated hepatic aneurysm with duodenal fistulization was observed.
After reviewing the case, surgical treatment is proposed as the first option but it is rejected by the patient. Thus, aneurysm embolization with coils and thrombin is performed, without further complications.
Selective embolization of the hepatic artery aneurysm is a therapeutic alternative in cases that implies large comorbidities, being an increasingly used technique.