2018 Volume 27 Issue 6 Pages 503-506
Hepatic artery aneurysms are rare, and recently, endovascular treatment has proven useful for managing abdominal visceral aneurysms. However, there have been few cases of the combination of endovascular treatment with surgical treatment. We herein report a case of endovascular treatment combined with surgery to manage a giant common hepatic artery aneurysm. A 79-year-old woman with anorexia and weight loss was found to have a mass on the posterior wall at the body of the stomach on gastroscopy. Abdominal enhanced computed tomography showed a splanchnic artery aneurysm of 10 cm. We diagnosed this mass as a common hepatic artery aneurysm because celiac angiography showed the presence of a giant aneurysm in the distal celiac artery located at the splenic artery bifurcation, and the giant aneurysm diverged into both the right hepatic artery and the gastroduodenal artery. We performed coil embolization of the splenic artery before laparotomy due to concerns that bleeding might become impossible to control. We made a gastrocolic ligament incision to reach the aneurysm and using sutures successfully closed the inflow pore from the celiac artery in the aneurysm. We then exfoliated the gastroduodenal artery and right hepatic artery of the outflow pore and performed reconstruction, successfully maintaining the blood flow of the liver. At two years after surgery, the patient has shown no liver damage or aneurysmal relapse. This surgery was able to be performed safely by combining the operation with endovascular treatment.
