A Case of Intrahepatic Aneurysm with Arterioportal Shunt

Taro Tateno, Shinichi Ueno, Masahiko Sakoda, Fumitake Kubo, Kiyokazu Hiwatashi, Tsunayuki Otsuka, Hiroshi Kurahara, Yukoh Mataki, Hiroyuki Shinchi and Syoji Natsugoe

Department of Surgical Oncology and Digestive Surgery, Kagoshima University School of Medicine

We report a case of intrahepatic aneurysm with aterioportal shunt. A 57-year-old woman was incidentally diagnosed with a hepatic artery aneurysm during an examination for hepatocellular carcinoma arised from hepatitis C virus-associated liver cirrhosis. Angiography revealed an aneurysm about 3 cm in diameter with an arterioportal shunt at the accessory left hepatic artery originating from the left gastric artery. Arterial embolization for the aneurysm was considered as treatment. However, since there were the collateral circulation and the arterioportal shunt, it was considered that the aneurysm was almost intractable with embolization alone. Therefore, left lobectomy of the liver was performed. Histopathological findings were consistent with true aneurysm. Although hepatic artery aneurysm is relatively rare, mortality from rupture is high. Recently, larger number of hepatic artery aneurysm diagnosed before rupture. For radical cure of the aneurysm, complete blockage of blood flow is necessary. Therefore, in case of intrahepatic aneurysm, the existence of collateral circulation is a major problem. Then careful consideration is required.

Key words
hepatic artery aneurysm, hepatectomy, arterio-portal shunt

Reprint requests
Taro Tateno Department of Surgical Oncology and Digestive Surgery, Kagoshima University, School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
July 23, 2008

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