Hepatic Artery Aneurysm: A Rare Presentation as Painless Obstructive Jaundice

The Aftermath of a Hepatic Artery Aneurysm—A Rare Etiology of Biliary Obstruction!

“…One-third of patients present with abdominal pain, obstructive jaundice, and hemobilia (Quincke triad). However, hemobilia alone can be the presenting feature in up to one-third of patients as described by Parmar et al, 7 mostly with intrahepatic aneurysms or pseudoaneurysms. Intraperitoneal bleeding is the most common manifestation of extrahepatic aneurysmal rupture or oozing.…”

Hepatic Artery Aneurysm/Pseudoaneurysm: An Unusual Cause of Upper Gastrointestinal (UGI) Bleeding and Biliary Obstruction Further Complicated by Glue Dislodgement Leading to Biliary Obstruction

“…Clinical presentation can be varied including abdominal pain, a pulsatile mass in the right upper quadrant, nausea/vomiting, and haemobilia. Obstructive jaundice can occur due to external compression of the CBD or intraductal blood clots secondary to fistula formation between the pancreatic and biliary ducts [5,6]. The triad of jaundice, biliary colic, and gastrointestinal bleeding, as seen in our patients is seen in up to 25% of patients [7][8][9].…”

Expand+In Vivoiv.iiarjournals.orgIn Vivo September-October 2017 vol. 31 no. 5 983-989 Management of a Fulminant Upper Gastrointestinal Bleeding Exteriorized Through Hemobilia Due to Arteriobiliary Fistula Between the Common Bile Duct and a Right Hepatic Artery Aneurysm – A Case Report

“…Most often patients with hepatic artery aneurysms are asymptomatic, although in certain cases symptoms such as right upper quadrant pain or jaundice mimicking cholelithiasis or common bile duct lithiasis might develop. The presence of painless jaundice as the first symptom leading to diagnosis is a rare event, only few cases being reported so far (6,10).…”

“…Due to this reason, in association with the presence of a patent accessory left hepatic artery arising from the left gastric artery the authors decided to tie off the aneurysm; this gesture did not induce any phenomena of liver ischemia. In the meantime, the common bile duct was divided during hepatic artery aneurysm resection, so a Roux en Y biliary reconstruction was associated (6).…”

“…In the study conducted by Stanley et al on 162 patients diagnosed with various splanchnic aneurysms, the authors demonstrated that 63% of cases reported common and proper hepatic artery aneurysms, 28% of cases were diagnosed with right hepatic artery aneurysms, 5% of cases presented left hepatic artery aneurysms while 4% of cases presented left and right hepatic artery aneurysms (5). Increasing incidence of reported hepatic artery aneurysms which has been reported in the last decade is mainly explained through the improvement of the imagistic techniques, offering a higher rate of aneurysms' detection especially among asymptomatic patients (6). Once hepatic aneurysms are diagnosed, performing an arteriography is mandatory in order to get information regarding the presence of collateral vascularization; once this maneuver is performed, surgery might be scheduled.…”