[Four patients with aneurysm of the hepatic artery].
Two men aged 73 and 71 years and 2 women aged 76 and 80 years were referred for a false aneurysm (the 3rd patient) or true aneurysm (the other 3 patients) of an extrahepatic portion of the hepatic artery. The first patient was asymptomatic, the third patient had a rupture in the biliary duct and the remaining 2 patients had upper abdominal pain. In the first 2 patients, the aneurysm was removed surgically and replaced with a venous interposition graft. The 3rd patient received a coated stent. In the 4th patient, the artery was occluded, after which hepatic circulation recovered spontaneously. Treatment was successful in all 4 patients. Aneurysm of the hepatic artery is identified increasingly more often due to the current capabilities of diagnostic imaging. Elective treatment is indicated if the diameter is > 2 cm due to the increased risk of rupture, which has been associated with mortality rates of up to 40%. Primarily, endovascular treatment should be considered by means of a coated stent or aneurysm coiling. For patients with compromised intestinal circulation, surgical elimination with venous reconstruction is the treatment of choice.
Ponfoort
E D
ED
St Antonius Ziekenhuis, Nieuwegein.
de van Pavoordt
H D W M
HD
Overtoom
T Th C
TT
The
R M
RM
de Vries
J P P M
JP
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000175:diagnosis* / Q000601:surgery; D017541:Aneurysm, False / Q000175:diagnosis; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods