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Post traumatic hepatic artery pseudoaneurysm

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

Bleeding gastric ulcer treated with endoclip. History of liver trauma 2 years prior.

Patient Data

Age: 70 years
Gender: Female

Saccular pseudoaneurysm with partial thrombosis of the proximal right hepatic artery (diameter 4.5 cm approximately).

Cavernoma in segment 8 of the liver.

Initial trauma CT 2 yr earlier

ct

Hepatic lacerations (segments 6 and 7) with hemoperitoneum.

In the arterial phase, there is a perfusion defect in the right lobe of the liver with flow interruption in the right branch of the hepatic artery which is surrounded by a hematoma.

Cavernoma in segment 8 of the liver.

Case Discussion

Hepatic artery aneurysms are rare. Rarer are those associated with a venous or biliary fistula. They tend to be saccular and multiple. Causes include infection, arteriosclerosis, trauma and vasculitis. Untreated aneurysms can lead to rupture into the common bile duct, peritoneum, or nearby hollow viscera.

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