Slovenská chirurgia 3/2013

Rupture of duplicate aneurysm of arteria hepatica – case report and review

47 years old woman was admitted in I. surgical clinic because of the signs of acute pancreatitis with epigastric pain, repeated vomiting and elevated amylase and oedema of the head of pacreas according to ultrasound. Patient falled into haemorrhagic shock during the third day of hospitalisation. Urgent CT detected the real diagnosis, patient was sent to angiologic department because of endovascular treatment of aneurysm of arteria hepatica. Coiling of one aneurysm with extrahepatal localisation was successful, on the other hand embolisation of the second branch failed because of vasospasm. Elective operative treatment was offered to patient, but she had to underwent urgent laparotomy and ligation because of suddenly rupture of affected artery in the size of 5x4 cm. Patient was sucessfully treated and dismissed in good condition. Aneurysm of hepatic artery is uncommon disease with 40% mortality in the case of it´s rupture.

Keywords: aneurysm, arteria hepatica, rupture, embolisation, ligation, mortality.