2024 Volume 57 Issue 10 Pages 491-497
A 56-year-old female presented to another hospital with a complaint of abdominal distention. She then visited our hospital for further examination and treatment because hemangioma of the liver was found to have increased and ascites had appeared. Abdominal contrast-enhanced CT showed an 11-cm hemangioma in the right lobe of the liver. The portal vein was dilated and strongly contrasted from the arterial phase. Ultrasound color Doppler imaging showed flow between the right branch of the portal vein and the hepatic artery on the hilar side of the tumor. The right branch of the portal vein had distal hepatic blood flow. The left umbilical branch and main trunk had afferent hepatic blood flow. Angiography showed early portal vein contrast and a 10-mm aneurysm of the posterior inferior pancreaticoduodenal artery. We considered that ascites effusion was caused by portal hypertension and the aneurysm was formed by increased demand of hepatic arterial blood flow, and resection of the hepatic hemangioma was planned. Transcatheter arterial embolization of the posterior inferior pancreaticoduodenal artery aneurysm was performed before surgery so that the aneurysm would not rupture due to hemodynamic changes in the perioperative period. Open right hepatic lobectomy was performed and the patient was discharged on the 12th day after a good postoperative course.
