Hepatic Artery Aneurysm Erosion into the Stomach: An Unusual Cause of Gastrointestinal Bleeding

Papafragkou, Sotirios; Haimovici, Lioudmila; Gonzalez, Edwin; Barrett, Leonard; Cirincione, Elizabeth

doi:10.1016/j.jemermed.2007.11.112

« Previous Next »The Journal of Emergency Medicine
Volume 39, Issue 1 , Pages 32-34, July 2010

Hepatic Artery Aneurysm Erosion into the Stomach: An Unusual Cause of Gastrointestinal Bleeding

Sotirios Papafragkou, MD
- Department of Surgery, Nassau University Medical Center, East Meadow, New York
- Reprint Address: Sotirios Papafragkou, md, Department of Surgery, Nassau University Medical Center, 126 Ava Drive, East Meadow, NY 11554
Lioudmila Haimovici, DO
- Department of Surgery, Nassau University Medical Center, East Meadow, New York
Edwin Gonzalez, MD, FACS
- Department of Surgery, Nassau University Medical Center, East Meadow, New York
Leonard Barrett, MD, FACS
- Department of Surgery, Nassau University Medical Center, East Meadow, New York
- Department of Vascular and Cardiothoracic Surgery, Nassau University Medical Center, East Meadow, New York
Elizabeth Cirincione, MD, FACS
- Department of Surgery, Nassau University Medical Center, East Meadow, New York
- Department of Colorectal Surgery, Nassau University Medical Center, East Meadow, New York

Received 12 March 2007; received in revised form 13 August 2007; accepted 5 November 2007. published online 24 October 2008.

Abstract

Background: Hepatic artery aneurysms are the second most common visceral aneurysms. The natural history of hepatic artery aneurysms typically results in enlargement, rupture, and life-threatening hemorrhage. Atherosclerosis, traditionally, has been the most common cause of hepatic artery aneurysm. Objective: A case of a hepatic artery aneurysm invading the stomach is presented to draw attention to the clinical presentation of this potentially catastrophic entity. Case Report: A 74-year-old man presented to the Emergency Department (ED) with hematemesis. He was hemodynamically stable with a hemoglobin of 10.5. Abdominal CT imaging revealed a hepatic artery aneurysm that eroded into the stomach. The erosion was successfully repaired operatively and the aneurysm was embolized. Conclusion: The most common symptom is epigastric pain. The clinical and radiological findings of a hepatic artery aneurysm eroding into the stomach with subsequent upper and lower gastrointestinal hemorrhage, as highlighted in the case reported, have received little prior attention in the medical literature.

Keywords: hepatic aneurysm, hematemesis, hematochezia