planchnic artery aneurysms (SAA) are seen rarely, but this entity is
clinically important.
1
Hepatic artery aneurysm (HAA) may be seen as
the true aneurysms or pseudoaneurysms. True HAA is the fourth most
common site of splanchnic artery aneursym, following infrarenal aorta, iliac
artery and splenic artery.
2
HAA accounts for approximately 20% of SAA,
80% of which are extrahepatic and solitary.
3,4
The rest are intrahepatic.
1-5
It
is known that 63% of HAAs involve the common hepatic artery. False ane-
urysms mostly occur in the right hepatic artery.
6
Previously, HAAs were
known to be frequently caused by mycotic infections and inflammation.
7,8
However currently, atherosclerosis is accepted as the most common cause
Damar Cer Derg 2013;22(1) 45
Surgical Repair of
a Hepatic Artery Aneurysm:
A Rare Case Report
ABSTRACT Hepatic artery aneurysms (HAAs) account for approximately 20% of splanchnic ar-
tery aneurysms (SAAs). Most of the SAAs are generally asymptomatic and detected incidentally.
Rupture of HAA is the first clinical manifestation in 80% of the cases. A 54-year-old female patient
whose HAA was incidentally detected with abdominal ultrasonography two years ago, was referred
to our clinic. Celiac artery angiography demonstrated a HAA in 4x6 cm diameters arising from the
common hepatic artery. Abdominal wall opened through a median incision. After 5000 IU of sys-
temic heparinization, proximal hepatic, distal hepatic and gastroduodenal arteries were clamped.
Aneurysm was removed and saphenous vein interposition was performed by end-to-end anasto-
mosis. Gastroduodenal artery end-to-side anastomosis was performed through the interposition of
a 2 cm saphenous vein. The patient was discharged uneventfully on the postoperative eighth day.
Key Words: Aneurysm; splanchnic circulation; hepatic artery aneurysms
ÖZET Hepatik arter anevrizmaları(HAA) intraabdominal organ anevrizmaların yaklaşık %20’sin-
den sorumludur. Batın içindeki organ anevrizmalarının çoğunluğu asemptomatiktir ve tesadüfen
tespit edilir. Batın ultrasonografi sırasında tesadüfen HAA tespit edilen 54 yaşındaki kadın hasta
kliniğimize kabul edildi. Çölyak arter anjiyografisinde ana hepatik arterden kaynaklanan 4x6 cm
çapında HAA tespit edildi. Batın median kesi ile açıldı. Takiben 5000 IU sistemik heparinizasyon
yapıldı ve proksimal, distal ve gastroduodenal arterler klemplendi. Anevrizma çıkarıldı, 6 cm uzun-
luğunda safen ven ile uç-uca anastomoz yapıldı. Gastroduodenal arter 2 cm’lik safen ven interpoze
edilerek uç-yan anastomoze edildi. Hasta post operatif 8. gün şifa ile taburcu edildi.
Anahtar Kelimeler: Anevrizma; splanknik dolaşım; hepatik arter anevrizması
Damar Cer Derg 2013;22(1):45-7
Kemalettin ERDEM,
a
Onursal BUĞRA,
a
Emine DAĞISTAN,
b
Orhan BOZOĞLAN,
c
Ümit YAŞAR TEKELİOĞLU,
d
Akçan AKKAYA,
d
Bahadır DAĞLAR
a
Departments of
a
Cardiovascular Surgery,
b
Radiology,
d
Anesthesiology and Reanimation,
Abant İzzet Baysal University
Faculty of Medicine, Bolu
c
Department of Cardiovascular Surgery,
Kahramanmaraş Sütçü İmam University
Faculty of Medicine, Kahramanmaraş
Geliş Tarihi/Received: 16.10.2012
Kabul Tarihi/Accepted: 02.01.2013
This case report was presented in
Turkish Society for Cardiovascular Surgery
12
th
National Congress, 8-11 November 2012,
Antalya, Turkey.
Yazışma Adresi/Correspondence:
Kemalettin ERDEM
Abant İzzet Baysal University
Faculty of Medicine,
Department of Cardiovascular Surgery,
Bolu,
TÜRKİYE/TURKEY
drkemalettincvs@yahoo.com
doi: 10.9739/uvcd.2012-32357
Copyright © 2013 by
Ulusal Vasküler Cerrahi Derneği
OLGU SUNUMU
Aortik Anevrizmalar, Cerrahi ve
Endovasküler Tedavisi