[Peripheral aneurysm of the hepatic artery as the etiology of acute upper gastrointestinal hemorrhage].
We report the case of a 64-year-old female with an intrahepatic aneurysm of the right hepatic artery. Initially uncharacteristic upper abdominal symptoms were followed by repeated upper gastrointestinal bleeding and, eventually, hemorrhagic shock. Finding the cause of severe hematemesis was challenging due to a previous Billroth-II gastric resection. Delayed diagnosis of hemobilia necessitated coeliacography, whereby an intrahepatic aneurysm of the right hepatic artery was found and, during the same session, super-selective embolization was achieved. If the cause of upper abdominal complaints remains unknown after routine diagnostic measures and the origin of bleeding in the upper gastrointestinal tract cannot be identified, aneurysms of abdominal arteries should be considered. Hemobilia of unknown etiology should always be an indication for coeliacography. The superselective angiographic embolization of intrahepatic aneurysms is a promising form of treatment with low risk.
Hanke
S
S
Klinik und Poliklinik für Viszeral-, Thorax- und Gefässchirurgíe, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden.
Ockert
D
D
Nagel
M
M
Köhler
K
K
Saeger
H D
HD
D000792:Angiography; D002445:Celiac Artery / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic; D005260:Female; D005743:Gastrectomy; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006431:Hemobilia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy