Sonographic diagnosis and follow-up of idiopathic hepatic artery aneurysm, an unusual cause of obstructive jaundice.
Hepatic artery aneurysms are rare. We report an idiopathic hepatic artery aneurysm causing obstructive jaundice in a case in which the common hepatic artery arose from the superior mesenteric artery. The diagnosis of hepatic artery aneurysm was suggested by gray-scale sonography, which showed that the common bile duct and intrahepatic biliary radicles were dilated with no obvious intraluminal abnormality and showed no evidence of a mass in the head of the pancreas. A papillotomy of the papilla duodeni major was performed to relieve the cholestasis. Repeat sonography 2 weeks later showed dilatation of the common bile duct and a cyst-like lesion at the porta hepatis impressing the anterior part of the common bile duct. Doppler sonography confirmed pulsatile flow within the cyst-like lesion. Helical CT showed a well-circumscribed lesion with a density similar to that of the abdominal aorta, and mesenteric angiography showed a 3-cm, smooth aneurysm arising from the common hepatic artery, which originated from the superior mesenteric artery. The aneurysm was successfully treated with transcatheter embolization.
Chandramohan
Department of Diagnostic Imaging, North Manchester General Hospital, Delauneys Road, Crumpsal, Manchester M8 5RB, United Kingdom.
Khan
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AN
Fitzgerald
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Sherlock
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Tam
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D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D002406:Catheterization, Peripheral; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000209:etiology; D004621:Embolization, Therapeutic; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000033:anatomy & histology; D008875:Middle Aged; D011859:Radiography; D018608:Ultrasonography, Doppler