Nonclassical Cause of Obstructive Jaundice: A Case Report of Multiple Visceral Arterial Aneurysms in a Young Patient

Hassan Adnan Bukhari,Noran Sultan,Waed Jameel

doi:10.4236/ojem.2020.83008

Abstract

Multiple visceral artery aneurysms are relatively rare; the rarest are superior mesenteric artery and gastroduodenal artery aneurysms. The clinical presentation depends on the size and site of the aneurysm. We report the case of a 33-year-old man with recurrent episodes of obstructive jaundice and weight loss. Computed tomography with contrast revealed scattered hepatic arterial aneurysms with two other aneurysms along the course of the left gastro-duodenal and superior mesenteric artery. Investigations to determine the etiology were negative, but the patient had a history of smoking and substance abuse. Angiography revealed an occluded feeding artery. The patient developed multiorgan failure, leading to cardiac arrest and died. Diagnosing multiple visceral artery aneurysms needs a high index of suspicion; early diagnosis enables early intervention, which can reduce the high mortality of this condition.

Highlights

Multiple visceral artery aneurysms (MVAA) are relatively rare, ranging between 0.1% - 0.2% of the total incidence of aneurysms
The initial presentation of MVAA can be deceiving, such as in this case, who presented with symptoms suggestive of obstructive jaundice, which is due to Gastroduodenal Artery Aneurysms (GDA)/superior pancreaticoduodenal artery (PDA) aneurysm [6]
MVAA is a challenging disease to diagnose initially due to its broad presentation, which depends on the site of the aneurysms

Summary

Introduction

Multiple visceral artery aneurysms (MVAA) are relatively rare, ranging between 0.1% - 0.2% of the total incidence of aneurysms. They can be defined as the presence of or more concomitant aneurysms in different arterial segments [3]. Clinical presentations of aneurysms vary depending on their size and site; patients may be asymptomatic. Certain imaging modalities are crucial in the diagnosis of arterial aneurysms, such as contrast enhanced computed tomography (CT), which is considered the gold standard [3]. Treatment of MVAAs depends on the size, site, and extent of the disease [5]. We report the case of a young man presenting with jaundice due to MVAA

Case Presentation

Findings

Discussion

Conclusion