Hepatic Artery Aneurysm

Abstract

<h3>To the Editor.—</h3> There have been 176 cases of hepatic artery aneurysm reported up to 1970. These are frequently fatal, and only about one-third reaching surgery survive. The clinical picture is marked by pain, a palpable mass, and jaundice, but the triad of pain, hemorrhage, and jaundice suggests a hepatic artery aneurysm. If the aneurysm ruptures, it usually does so into the peritoneal cavity, the common duct, or, less often, into the duodenum, gallbladder, or stomach. If time allows, retrograde aortography should be employed preoperatively. In the hemorrhagic case, prompt and aggressive surgery is necessary. Ligation of the common hepatic artery is satisfactory, and we have always been instructed that the ligature should be placed proximal to the origin of the gastroduodenal artery. Then the collateral circulation via the superior mesenteric artery prevents hepatic necrosis. It has always been recommended that if the common hepatic artery is ligated distal to