Hepatic artery aneurysm: an unusual cause for gastrointestinal haemorrhage

Aneurysms of the hepatic artery are rare. The presenting features include abdominal pain, which may be associated with a mass. More acutely, patients present with signs of hypovolaemia secondary to rupture. The patient reported here presented with gastrointestinal haemorrhage of unknown aetiology. A computed tomography scan showed an aneurysm of a visceral artery. Subsequent angiography confirmed the presence of a leak in the hepatic artery. The patient refused surgical intervention and improved with supportive treatment only.     

Hepatic artery aneurysm,an unusual cause of obstructive jaundice: MR cholangiography findings

Hepatic artery aneurysms are rare vascular lesions, often with a nonspecific clinical presentation, and difficult to diagnose before rupture. We report the case of a patient with obstructive jaundice caused by a compression on the right biliary duct by a right hepatic artery aneurysm in which the diagnosis was suggested by magnetic resonance cholangiography and confirmed by Doppler sonography and preoperative digital subtraction angiography.     

Sonographic diagnosis and follow-up of idiopathic hepatic artery aneurysm, an unusual cause of obstructive jaundice.

Hepatic artery aneurysms are rare. We report an idiopathic hepatic artery aneurysm causing obstructive jaundice in a case in which the common hepatic artery arose from the superior mesenteric artery. The diagnosis of hepatic artery aneurysm was suggested by gray-scale sonography, which showed that the common bile duct and intrahepatic biliary radicles were dilated with no obvious intraluminal abnormality and showed no evidence of a mass in the head of the pancreas. A papillotomy of the papilla duodeni major was performed to relieve the cholestasis. Repeat sonography 2 weeks later showed dilatation of the common bile duct and a cyst-like lesion at the porta hepatis impressing the anterior part of the common bile duct. Doppler sonography confirmed pulsatile flow within the cyst-like lesion. Helical CT showed a well-circumscribed lesion with a density similar to that of the abdominal aorta, and mesenteric angiography showed a 3-cm, smooth aneurysm arising from the common hepatic artery, which originated from the superior mesenteric artery. The aneurysm was successfully treated with transcatheter embolization.     

Atheromatous embolization to the stomach: an unusual cause of gastrointestinal bleeding.

This is a case report of an 80-year-old female with persistent blood loss from what was initially considered to be "hemorrhagic gastritis." Distal gastrectomy showed extensive atheromatous embolism and resultant ischemic lesions of the stomach--the apparent cause of the chronic bleeding. The patient has remained well without further blood loss during a 15-month follow-up period. While a small number of cases of gastric hemorrhage associated with atheromatous embolism have been reported, they all have been diagnosed at autopsy. This case is unusual in that the lesion was successfully delt with by surgical resection of the involved area.     

Polypoid angiodysplasia: an unusual cause of lower gastrointestinal bleeding

Angiodysplasia is one of the most leading causes of lower gastrointestinal bleeding in elderly patients. Polypoid angiodysplasia is extremely rare; however, in the literature, a few cases have been reported as single polypoid lesion from Eastern countries. The lesions in our case were multiple polypoid, octopus-like, and were associated with diverticula. We managed to remove the polypoid angiodysplasia using snare polypectomy. This is the first reported case of multiple polypoid angiodysplasia associated with diverticula.     

Hemobilia: Calcified hepatic artery aneurysm presenting with massive gastrointestinal bleeding

A case of a calcified and ruptured hepatic artery aneurysm presenting with hemobilia and massive gastrointestinal bleeding is reported and illustrated. The clinical diagnosis should be entertained whenever the trial of findings (abdominal colic, gastrointestinal bleeding, elevated bilirubin levels) is present. Angiography is the method of choice in confirming this diagnosis. A short review of the clinical and radiographic syndrome of hemobilia with emphasis on the occurence, significance, and prognosis of hepatic artery aneurysms is presented.     

Hepatic artery aneurysm: CT and MR features

The authors report a case of common hepatic artery aneurysm diagnosed by computed tomography (CT) and magnetic resonance (MR). Features of both techniques are described and discussed. The surgical and radiologic literature is reviewed.     

Gastric antral angiodysplasia: an unusual cause of occult gastrointestinal bleeding

A patient with chronic occult gastrointestinal bleeding proved to have multiple gastric antral angiodysplasias and was treated with distal gastric resection. The diagnosis of this lesion is occasionally made endoscopically, since its submucosal nature makes barium contrast studies of no value. Arteriograms will also be helpful in some circumstances. Resection offers the best likelihood for permanent success.     

超声诊断肝动脉假性动脉瘤合并败血症1例

患者男,32岁,因"反复发热1月余"入院,伴畏寒、头痛、全身肌肉酸痛等.实验室检查:白细胞12.21×109/L,中性粒细胞占84.8％,降钙素原0.72 μg/L,谷丙转氨酶112 IU/L,谷草转氨酶64IU/L.血培养:嗜沫凝聚杆菌阳性.心脏彩色多普勒超声心动图、脑脊液检查、头部MRI及胸部CT提示感染性心内膜炎...     

Dissecting aneurysm of the basilar artery as a cause of orgasmic headache

A 39-year-old woman experienced recurrent, severe bursting headache which was abruptly developed at the time of orgasm. Both magnetic resonance angiography and conventional angiogram of the brain confirmed dissecting aneurysm of the basilar artery. After the neuroradiological intervention using a stent was performed, she has been totally free of the orgasmic headache during the follow-up period for about one year.     

Sonographic diagnosis of a giant aneurysm of the common hepatic artery

Hepatic artery aneurysms are rare vascular lesions sometimes found incidentally during abdominal imaging. We present the case of a 61-year-old man whose initial symptoms were tenderness in the right upper quadrant of the abdomen and epigastric pain. Gray-scale sonography revealed ascites and an 8.1-cm mass in the region of the porta hepatis; color Doppler sonography revealed a turbulent arterial waveform with high peak systolic velocity. We diagnosed a giant aneurysm of the common hepatic artery. Three-dimensional CT angiography confirmed this diagnosis and also revealed hemoperitoneum. The patient underwent aneurysmectomy and recovered well. This case shows that the use of both sonography and CT angiography offers a promising alternative to conventional angiography for the diagnosis of and treatment planning for hepatic artery aneurysms.     

Hepatic angiosarcoma: an unusual cause of congestive heart failure

Hepatic angiosarcoma is a rare form of liver cancer. The history, physical examination, and liver biopsy are nonspecific. As a result, diagnosis of angiosarcoma can be challenging. We report the case of an elderly woman with congestive heart failure caused by a hepatic angiosarcoma. The massive tumor burden created extensive arteriovenous shunting and a high-cardiac-output state.