Open Repair of an Incidentally Diagnosed Hepatic Artery Aneurysm

Hepatic artery aneurysms (HAA) are rare. Eighty per cent of patients present acutely with aneurysm rupture, with an attended high mortality. Diagnosis is difficult and often delayed, owing to the non-specific symptoms and lack of clinical findings [1,2]. A review of the literature showed that the HAA had surpassed splenic artery aneurysm (SAA) as the most frequently reported visceral artery aneurysm [3]. This recent trend is thought to be due to the proliferation of centres performing invasive diagnostic and therapeutic hepatobiliary procedures, many of which have hepatic artery pseudo-aneurysm formation as a recognised complication [4]. The natural history of HAA is poorly understood, however, it is suggested that mortality following spontaneous rupture is as high as 40%. Statistics such as these sanction an aggressive approach to the management of the HAA [5,6].