Ruptured Hepatic Artery Aneurysm: A Rare Fatal Cause of Obstructive Jaundice

Abstract

Background: Hepatic artery aneurysms (HAA) are rare vascular lesions, often with a nonspecific clinical presentation and difficult to diagnose before rupture. We present a case of radiologically diagnosed ruptured HAA that cause obstructive jaundice. Case Report: A 56-yearold woman presented with a 2-month history of upper abdominal pain and progressive jaundice. Physical examination showed hypotension, tachycardia, icteric sclera, pale conjunctiva, epigastric tenderness, and hypoactive bowel sound. Laboratory findings were compatible with obstructive jaundice. Abdominal ultrasonography revealed a cyst-like lesion at the porta hepatis and dilated intrahepatic biliary ducts. Subsequently, contrast-enhanced CT of the upper abdomen showed a well-circumscribed lesion with a density similar to that of the contrast medium-filled abdominal aorta suggesting aneursym of the hepatic artery, and a perianeurysmal hypodensity reflecting leakage of the ruptured aneurysm. During the radiological procedure, the patient’s condition deteriorated. Angiography was planned but could not be performed due to technical problems. Thereafter, emergency operation was done 5 h after admission, but the patient died intraoperatively due to massive intraabdominal bleeding. Conclusion: HAA is a rare vascular lesion that should be considered in cases of unexplained obstructive jaundice.

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].…”