Hepatic artery aneurysm associated with upper gastrointestinal bleeding after intrahepatic artery chemotherapy

We present the course of illness of a 56 year-old patient with acute gastro intestinal bleeding after penetration of an aneurysm of the hepatic artery in the duodenal bulb. A diffuse intrahepatic metastasis of a carcinoid was treated with a loco-regional intraarterial chemotherapy via a catheter syst em implanted in the gastroduodenal artery. Five months after the catheter i mplantation melena occurred. The gastrointestinal arterial bleeding from th e penetrating aneurysm presented a life-threatening situation. This cause o f bleeding could not be brought under control endoscopically. Immediate sur gical management became necessary.