[A case of hepatic artery aneurysm that had formed asymptomatically and penetrated into the duodenum].
A 41-year-old man was admitted to our hospital with gastrointestinal bleeding. Esophagogastroduodenoscopy revealed a submucosal protrusion with erosion in the duodenal bulb which was thought to be the bleeding source. Dynamic CT scan, ultrasonography and angiography of the abdomen revealed a hepatic artery aneurysm and a dilated celiac artery that dissected from its origin. Although we considered percutaneous transcatheter arterial embolization with metallic coils, we chose surgical resection and vascular reconstruction to prevent hepatic ischemia resulting from interruption of collateral circulation. On the 8(th) day, hepatic artery aneurysmectomy and revascularization with a great saphenous vein was carried out without any severe complication. The pathological specimen demonstrated segmental arterial mediolysis.
Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Japan.
Ken
K
Hatogai
Atsushi
A
Nakazawa
Maiko
M
Takita
Ryouhei
R
Kishino
Eri
E
Seki
Eisuke
E
Iwasaki
Motoko
M
Izumiya
Norio
N
Maeda
Katsuhiko
K
Motegi
Kiyoshi
K
Mukai
Nobuhiro
N
Tsukada
D000328:Adult; D000783:Aneurysm / Q000175:diagnosis / Q000473:pathology*; D002445:Celiac Artery; D004386:Duodenum / Q000473:pathology*; D006499:Hepatic Artery; D006801:Humans; D008297:Male