Two Cases of Ruptured Hepatic Artery Aneurysm Complicating with Hepatic Artery Infusion Chemotherapy

Tetsunori Yoshimura, Hitoshi Fujiwara, Yasuhiko Tanioka, Ken-ichro Hamagashira, Masao Kobayashi, Shinhachiro Nomi

Department of Surgery, Social Insurance Kyoto Hospital

Two cases of ruptured hepatic artery aneurysm complicating hepatic artery infusion chemotherapy (HAIC) are reported. The first was a 57-year-old man, who had undergone resection of the posterior segment of the liver because of metastasis from rectal cancre. An intraarterial infusion catheter with a reservoir was placed in the common hepatic artery through the gastroduodenal artery. After two weeks of HAIC treatment, computed tomography and angiography revealed an aneurysm of the common hepatic artery. HAIC was interrupted, but while waiting for the scheduled operation the patient had massive hematemesis with bleeding which produced hypovolemic shock. Emergency laparotomy showed rupture of the aneurysm into the duodenum. The second case was an 89-year-old man, who had received HAIC for almost two years. He was admitted to the hospital because of right hypochondral pain and melena. ERCP showed hemobilia and computed tomography and angiography revealed an aneurysm of the hepatic artery. Transcatheter embolization was performed, but he died of sepsis associated with hepatic abscess. Hepatic artery aneurysm complicating HAIC is rare, but we consider this potentially serious complication to merit documentation.

Key words
hepatic artery aneurysm, hepatic infusion chemotherapy, intraarterial infusion catheter

Reprint requests
Tetsunori Yoshimura Department of Surgery, Social Insurance Kyoto Hospital
27 Koyamashimofusa-cho, Kita-ku, Kyoto, 602 JAPAN

Accepted
May 21, 1997

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