title: Gastrointestinal bleeding and obstructive jaundice: Think of hepatic artery aneurysm.
abstract: Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries. Spontaneously ruptured aneurysm of the hepatic artery is seldom described. We report the case of an 89-year-old woman presenting with abdominal pain, jaundice and gastrointestinal bleeding, whose ultrasound and computed tomography revealed a non-traumatic, spontaneous aneurysm of the right hepatic artery. The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater, nor anywhere else. Selective angiography confirmed the diagnosis of hepatic artery aneurysm and revealed a full hepatic artery originating from the superior mesenteric artery. The patient was successfully treated by selective embolization of microcoils. We discuss the etiologies of hemobilia and its treatment with selective embolization, which remains favored over surgical treatment. Although aneurysm of the hepatic artery is rare, especially without trauma, a high index of suspicion is needed in order to ensure appropriate treatment.
authors.affiliation: Fabrice Vultaggio, Michel Christodoulou, Didier Roulin, Service de Chirurgie Générale, Hôpital du Valais, 1950 Sion, Switzerland.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Vultaggio
authors.affiliation: Fabrice Vultaggio, Michel Christodoulou, Didier Roulin, Service de Chirurgie Générale, Hôpital du Valais, 1950 Sion, Switzerland.
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Morère
authors.affiliation: Fabrice Vultaggio, Michel Christodoulou, Didier Roulin, Service de Chirurgie Générale, Hôpital du Valais, 1950 Sion, Switzerland.
authors.forename: Christophe
authors.initials: C
authors.lastname: Constantin
authors.affiliation: Fabrice Vultaggio, Michel Christodoulou, Didier Roulin, Service de Chirurgie Générale, Hôpital du Valais, 1950 Sion, Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Christodoulou
authors.affiliation: Fabrice Vultaggio, Michel Christodoulou, Didier Roulin, Service de Chirurgie Générale, Hôpital du Valais, 1950 Sion, Switzerland.
authors.forename: Didier
authors.initials: D
authors.lastname: Roulin
keywords: Gastrointestinal hemorrhage; Hemobilia; Hepatic artery aneurysm; Obstructive jaundice; Supra-selective micro-embolization