Sonographic diagnosis and follow-up of idiopathic hepatic artery aneurysm,an unusual cause of obstructive jaundice

Hepatic artery aneurysms are rare. We report an idiopathic hepatic artery a neurysm causing obstructive jaundice in a case in which the common hepatic artery arose from the superior mesenteric artery. The diagnosis of hepatic artery aneurysm was suggested by gray-scale sonography, which showed that t he common bile duct and intrahepatic biliary radicles were dilated with no obvious intraluminal abnormality and showed no evidence of a mass in the he ad of the pancreas. A papillotomy of the papilla duodeni major was performe d to relieve the cholestasis. Repeat sonography 2 weeks later showed dilata tion of the common bile duct and a cyst-like lesion at the porta hepatis im pressing the anterior part of the common bile duct. Doppler sonography conf irmed pulsatile flow within the cyst-like lesion. Helical CT showed a well- circumscribed lesion with a density similar to that of the abdominal aorta, and mesenteric angiography showed a 3-cm, smooth aneurysm arising from the common hepatic artery, which originated from the superior mesenteric arter y. The aneurysm was successfully treated with transcatheter embolization. ( C) 2001 John Wiley & Sons, Inc.