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Hepatic artery aneurysm (HAA) is a rare occurrence, comprising of approximately 20% of splanchnic aneurysms. Rupture of HAA can lead to potentially disastrous complications like hemobilia, cholangitis and upper gastrointestinal bleeding.
We report a case of a 55-year-old lady who presented to us with intermittent upper abdominal pain and fever for the past one month. She lost 4 kg in a month. Physical examination revealed a pulsatile mass at the epigastrium. Blood investigation was unremarkable. Computed tomographic scan revealed a large saccular aneurysm of the common hepatic artery measuring 6.6x7.3x9.3cm with intramural thrombus seen within. The gastroduodenal artery is was being displaced posterolaterally by the aneurysm and is was small in caliber. The hepatic artery proper, the left hepatic artery and the right hepatic artery are were normal. Normal pancreatic parenchyma was only seen at the uncinate process and head of the pancreas. The adrenals, liver, spleen and both kidneys are normal. She was offered surgery or endovascular coiling of the aneurysm but she refused.
HAA carries a high morbidity and mortality rate. CTA will help to aid into the diagnosis. It can be treated surgically or by endovascular.
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