Gastrointestinal bleeding and obstructive jaundice: Think of hepatic artery aneurysm  

作　　者：Fabrice Vultaggio Pierre-Henri Morère Christophe Constantin Michel Christodoulou Didier Roulin 

机构地区：[1]Service de Chirurgie Generale, Hopital du Valais, 1950 Sion, Switzerland [2]Département d’Imagerie Medicale et Radiologie Interventionnelle, Hopital deSierre, 1950 Sion, Switzerland [3]Service de Chirurgie, Hopital de Sierre 3960 Sierre, Switzerland

出　　处：《World Journal of Gastrointestinal Surgery》2016年第6期467-471,共5页世界胃肠外科杂志（英文版）（电子版）

摘　　要：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.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.

关 键 词：HEMOBILIA Hepatic artery ANEURYSM OBSTRUCTIVE JAUNDICE Supra-selective micro-embolization Gastrointestinal HEMORRHAGE 

分 类 号：R735.7[医药卫生—肿瘤]