Present management of hepatic artery aneurysms. Symptomatic left hepatic artery aneurysm; right hepatic artery aneurysm with erosion into the gallbladder and simultaneous colocholecystic fistula--a report of two unusual cases and the current state of etiology, diagnosis, histology and treatment.
A left hepatic artery aneurysm has an incidence of 0.8% among the splanchnic artery aneurysms. 20% of splanchnic artery aneurysms are hepatic artery aneurysms. Atherosclerosis (32%) is the most prevalent etiology, followed by trauma (22%) and inflammatory lesions (10%). The average age is 40 (10-83) years, the male to female ratio 2:1. In 64-80% of cases rupture of the aneurysm is the first clinical manifestation. The mortality is then about 35%. The case of a 64 years old female with a symptomatic aneurysm of the left hepatic artery and the case of a 70 years old female, who underwent emergency laparotomy for acute colorectal hemorrhage, with a right hepatic artery aneurysm, which perforated into the gallbladder, with simultaneous colocholecystic fistula is reported and the etiology, histology, and present diagnostic and therapeutic management of hepatic artery aneurysms is discussed.
Psathakis
D
D
Department of Surgery, University of Lübeck, FRG.
Müller
G
G
Noah
M
M
Diebold
J
J
Bruch
H P
HP
D000368:Aged; D000783:Aneurysm / Q000473:pathology / Q000601:surgery*; D001658:Biliary Fistula / Q000473:pathology / Q000601:surgery*; D003108:Colonic Diseases / Q000473:pathology / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005705:Gallbladder Diseases / Q000473:pathology / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000473:pathology / Q000601:surgery*; D006499:Hepatic Artery / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D012422:Rupture, Spontaneous