Successful treatment of hepatic artery aneurysm with erosion into the common duct

Abstract

A patient with an hepatic artery aneurysm is presented with preoperative angiographs, and intra-operative photographs demonstrating erosion and fistulazation into the common duct. The aneurysm was ligated and excised, and the erosion of the common duct was treated successfully with a Roux-en-Y choledochoduodenstomy. This is the fourth case with erosion into the common duct to be treated successfully by surgery. The other three cases are discussed. A review of the literature reveals that hepatic artery aneurysms are rare, and successful treatment is based on several different techniques. Ligation of the hepatic artery, with or without excision of the aneurysm, is discussed as a method that may in fact be the safest treatment in a group of patients who because of their disease are already in a high risk category.