Wen X, Yao ZY, Zhang Q, Wei W, Chen XY, Huang B. Surgical repair of an emergent giant hepatic aneurysm with an abdominal aortic dissection: A case report. World J Clin Cases 2022; 10(17): 5798-5804 [PMID: 35979095 DOI: 10.12998/wjcc.v10.i17.5798]
Corresponding Author of This Article
Bin Huang, PhD, Professor, Department of Vascular Surgery West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. xgwkhb@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xin Wen, Xi-Yang Chen, Department of Vascular Surgery, West China Hospital, Chengdu 610041, Sichuan Province, China
Zuo-Yi Yao, Qian Zhang, Wei Wei, Department of General Surgery, Chengdu Fifth People's Hospital, Chengdu 611100, Sichuan Province, China
Bin Huang, Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wen X was responsible for collecting the information and writing the article; Yao ZY was involved in surgery and communication with the patient; Zhang Q participated in surgery and data collection; Wei W participated in surgery; Chen XY revised the article; Huang B designed the surgical plan and participated in the surgery; all authors have read and approved the final manuscript.
Informed consent statement: The patient provided informed written consent prior to study enrollment.
Conflict-of-interest statement: This article is not supported by funding and has no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Huang, PhD, Professor, Department of Vascular Surgery West China Hospital of Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. xgwkhb@126.com
Received: November 23, 2021 Peer-review started: November 23, 2021 First decision: February 7, 2022 Revised: February 27, 2022 Accepted: April 15, 2022 Article in press: April 15, 2022 Published online: June 16, 2022
Abstract
BACKGROUND
Hepatic artery aneurysm (HAA) is the second most common visceral aneurysm. A significant number of hepatic aneurysms are found accidentally on examination. However, their natural history is characterized by their propensity to rupture, which is very serious and requires urgent treatment. An emergent giant hepatic aneurysm with an abdominal aortic dissection is less commonly reported.
CASE SUMMARY
We report the complicated case of a giant hepatic aneurysm with an abdominal aortic dissection. A 66-year-old female presented with the complaint of sudden upper abdominal pain accompanied by vomiting. Physical examination showed that her blood pressure was 214/113 mmHg. Her other vital signs were stable. Computed tomography found a giant hepatic proper aneurysm and dissection of the lower segment of the abdominal aorta. Furthermore, angiography showed a HAA with the maximum diameter of approximately 56 mm originating from the proper hepatic artery and located approximately 15 mm from the involved bifurcation of the left and right hepatic arteries with no collateral circulation. Therefore, we decided to use a stent to isolate the abdominal aortic dissection first, and then performed open repair. After the operation, the patient recovered well without complications, and her 3-month follow-up checkup did not reveal any late complications.
CONCLUSION
Open surgery is a proven method for treating giant hepatic aneurysms. If the patient's condition is complex, staged surgery is an option.
Core Tip: We report a relatively rare case of a giant hepatic aneurysm combined with abdominal aortic coarctation. The patient had an acute onset and was treated for abdominal aortic coarctation after blood pressure control, followed by a second stage open surgery to manage the hepatic aneurysm in a comprehensive manner. The patient's prognosis is good.
