An 80-year-old man was admitted to the Emergency Department with abdominal pain and mild jaundice (direct bilirubin level: 2 mg/dL). The hemodynamic parameters were stable. The medical history was remarkable for cholelithiasis and severe lumbosacral spondylosis associated with back pain that was responsive to nonsteroidal anti-inflammatory drugs; there was no history of arterial hypertension, pancreatitis, abdominal trauma, or arterial dysplasia. On physical examination, the patient was in good health. A nontender mass was palpated in the right upper quadrant of the abdomen. The ultrasound revealed a voluminous inhomogeneous mass (10.6 cm in maximum diameter) in the right upper abdomen with a hypoechoic half represented by blood flow and the other half with heterogenous echogenicity. The finding was suspected because of a sacciform partially thrombosed aneurysm of the common hepatic artery (Figure 1) obstructing the common biliary duct. Multidetector-row contrast-enhanced computed tomography (CT) scan (Figure 2) confirmed the diagnosis of a giant sacciform common hepatic aneurysm. Following the patient's admission to the surgical department, a magnetic resonance imaging (MRI) study was performed to accurately define the compressive effect at the level of the hepatic hilum and the intrahepatic biliary tree dilatation (Figure 3).
Giant Hepatic Artery Aneurysm: A Fatal Evolution
Rebonato, Alberto;CAGINI, Lucio;SCIALPI, Michele
2013
Abstract
An 80-year-old man was admitted to the Emergency Department with abdominal pain and mild jaundice (direct bilirubin level: 2 mg/dL). The hemodynamic parameters were stable. The medical history was remarkable for cholelithiasis and severe lumbosacral spondylosis associated with back pain that was responsive to nonsteroidal anti-inflammatory drugs; there was no history of arterial hypertension, pancreatitis, abdominal trauma, or arterial dysplasia. On physical examination, the patient was in good health. A nontender mass was palpated in the right upper quadrant of the abdomen. The ultrasound revealed a voluminous inhomogeneous mass (10.6 cm in maximum diameter) in the right upper abdomen with a hypoechoic half represented by blood flow and the other half with heterogenous echogenicity. The finding was suspected because of a sacciform partially thrombosed aneurysm of the common hepatic artery (Figure 1) obstructing the common biliary duct. Multidetector-row contrast-enhanced computed tomography (CT) scan (Figure 2) confirmed the diagnosis of a giant sacciform common hepatic aneurysm. Following the patient's admission to the surgical department, a magnetic resonance imaging (MRI) study was performed to accurately define the compressive effect at the level of the hepatic hilum and the intrahepatic biliary tree dilatation (Figure 3).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.