Spontaneous Rupture of a Congenital Hepatic Artery Aneurysm

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Abstract
A 74-year-old woman with new, but vague abdominal pain developed an intra-abdominal hemorrhage. Ultrasound and CT scans before and after this event demonstrated an acute hepatic lesion with hemorrhage into the peritoneal cavity. The patient died, and a ruptured hepatic artery aneurysm was revealed at autopsy. Hepatic artery aneurysm is uncommon, usually extra-hepatic, and, in most cases, is caused by atherosclerosis, medial degeneration, trauma, or infection. In this case, the aneurysm was intrahepatic and no underlying abnormalities of the hepatic vessels were found. We discuss the clinical scenario of patients with hepatic artery aneurysm and stress the importance of considering the diagnosis in the setting of a catastrophic abdominal event. In addition, the various diagnostic and therapeutic options are explored.

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