Author(s)

Salamata Diallo^1*, Alioune Badara Fall¹, Mamadou Lamine Gueye², Marie Louise Bassene¹, Mamadou Ngoné Gueye³, Marieme Polele Fall¹, Mame Aissé Thioubou⁴, Alsine Yauck¹

¹Department of Gastroenterology and Hepatology, Hospital Aristide Le Dantec, Dakar, Senegal.
²Department of General Surgery, Hospital Aristide Le Dantec, Dakar, Senegal.
³Department of Gastroenterology and Hepatology, Hospital Idrissa Pouye, Dakar, Senegal.
⁴Department of Gastroenterology and Hepatology, Peace Hospital, Ziguinchor, Senegal.

Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally asymptomatic disease when symptomatic, they usually present with abdominal pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia secondary to rupture or GI bleeding with normal GI endoscopy. Surgical repair and endovascular treatment are the two therapeutic options available at present. Case report: A 49-year-old male presented at the emergency department with high gastrointestinal bleeding, abdominal pain and jaundice. Gastroscopy showed an ulcer with flat pigmented haematin on ulcer base (Forrest IIc) that was controlled by medical treatment. CT angiography was done and showed aneurysm of the proper hepatic artery almost totally thrombosed measuring 100 × 59 mm associated with signs of contained rupture. Emergency surgery was indicated. The laparotomy objectified a rupture of the aneurysm in the biliary tree in per operative excision of aneurysm and ligation of the hepatic pedicle was carried out. After surgery, the evolution was favorable with a follow-up of 8 months. Conclusion: HAA rupture is a rare cause of upper GI bleeding. The mortality rate after rupture is relatively high. CT angiography or MRI can diagnose a ruptured of HAA. Urgent surgery should be the first choice in patients with a ruptured HAA with active hemorrhage causing hemorrhagic shock.

Hepatic Artery Aneurysm, Rupture, Upper GI Bleeding, Surgery

Diallo, S. , Fall, A. , Gueye, M. , Bassene, M. , Gueye, M. , Fall, M. , Thioubou, M. and Yauck, A. (2022) Hepatic Artery Aneurysm: An Unusual Cause of Upper Gastrointestinal Bleed in 49 Years Old Patient. Open Journal of Gastroenterology, 12, 64-70. doi: 10.4236/ojgas.2022.123007.