A case of ruptured left hepatic artery aneurysm with acute aortic dissection

Abstract

A 40-year-old man was admitted to our hospital for the treatment of acute aortic dissection. After admission, he developed epigastric pain and rebound tenderness. Abdominal enhanced CT showed intraperitoneal hemorrhage and a hepatic artery aneurysm. Since he was hemodynamically stable without anemia, we closely followed the patient overnight. The next day, he developed shock, and therefore, we decided to perform laparotomy instead of transcatheter embolization, which was contraindicated due to aortic dissection. Intraoperative findings revealed a ruptured left hepatic artery aneurysm, for which we performed aneurysmectomy and ligation of the left hepatic artery. The patient was discharged on postoperative day 39 after the mild liver dysfunction improved. The aortic dissection was the thrombotic type, which has been stable.