Home > Journals > Italian Journal of Vascular and Endovascular Surgery > Past Issues > Giornale Italiano di Chirurgia Vascolare 2001 June;8(2) > Giornale Italiano di Chirurgia Vascolare 2001 June;8(2):117-24

CURRENT ISSUE
 

ARTICLE TOOLS

Reprints

ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Emerging Sources Citation Index, Scopus


eTOC

 

CLINICAL CASES  


Giornale Italiano di Chirurgia Vascolare 2001 June;8(2):117-24

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English, Italian

Hepatic artery aneurysm secondary to acute pancreatitis

Fusari M., Agostinelli A., Esposito G., Parolari A.

From the Vascular Surgery Operative Unit, Cliniche Gavazzeni, Bergamo Department of Heart Surgery, “Fondazione Monzino” Cardiology Centre, University of Milan, Milan


PDF  


Hepatic ­artery aneu­rysms rep­re­sent ­about 40% of all vis­cer­al aneu­rysms. While the eti­ol­o­gy is ­often ath­e­ros­cle­rot­ic, trau­mat­ic or inflam­ma­to­ry, the ­release of pan­creat­ic ­enzymes dur­ing ­acute pan­crea­titis may pro­mote the ­onset of ­these ­lesions to the per­i­pan­creat­ic arter­ies in ­some cas­es. The treat­ment of ­these aneu­rysms ­entails restor­ing the integ­rity of the vas­cu­lar ­axis affect­ed by the ­lesion or its exclu­sion ­from the ­blood ­flow ­based on the ana­tom­ic var­i­abil­ity of the hepat­ic col­lat­er­al cir­cu­la­tion and in par­tic­u­lar the ori­gin of the gas­trod­u­od­en­al ­artery com­pared to the ­site of the aneu­rysm. Both ­these solu­tions can be ­achieved ­using tra­di­tion­al sur­gi­cal tech­niques, ­using liga­tion of the com­mon hepat­ic ­artery or ­graft replace­ment, and ­with endo­vas­cu­lar radio­log­i­cal meth­ods ­such as embol­isa­tion of the aneu­rysm ­using met­al ­coils or the inser­tion of vas­cu­lar ­stents. The pre­op­er­a­tive diag­nos­tic ­iter ­includes ultra­so­nog­ra­phy and abdom­i­nal CT ­with con­trast medi­um and selec­tive angio­gra­phy of the ­celiac ­trunk and pos­sibly the super­i­or mes­en­ter­ic ­artery in ­order to ­make an accu­rate eval­u­a­tion of hepat­ic cir­cu­la­tion. We ­report the ­case of a ­female ­patient ­with an aneu­rysm of the com­mon hepat­ic ­artery involv­ing the ori­gin of the gas­trod­u­od­en­al ­artery sec­on­dary to hemor­rhag­ic ­acute pan­crea­titis. The ­patient under­went sur­gi­cal aneu­rys­mec­to­my and replace­ment of the com­mon hepat­ic ­artery ­with vas­cu­lar ­grafts in ­PTFE ­which ­were anas­tom­ised prox­i­mal­ly to the ­start of the gas­trod­u­od­en­al ­artery. This meth­od ­allowed the aneu­rysm to be ­removed ­while pre­serv­ing ade­quate hepat­ic per­fu­sion.

top of page

Publication History

Cite this article as

Corresponding author e-mail