Ruptured hepatic artery dissection: case report

Abstract

Dissections of splanchnic arteries are rare but important vascular lesions associated with high mortality. We describe a case of ruptured hepatic artery dissection in a 72-year-old woman found deceased after being unwell with diarrhoea and vomiting for 3 days. Autopsy showed haemoperitoneum of approximately 1 litre of blood and blood clot. Histological examination revealed hepatic artery dissection with medial-adventitial separation associated with a neutrophilic infiltrate, which appeared to be most likely a secondary effect rather than an underlying vasculitic process. The deceased had hypertension, which is associated with a large proportion of reported cases of hepatic artery dissection. However, no specific underlying cause was identified. Clinical features and aetiology of hepatic artery dissection will be discussed.