Current trends in the diagnosis and treatment of hepatic artery aneurysms.
Aneurysms of the hepatic artery are rare lesions that constitute 20% of all splanchnic artery aneurysms. Their well-documented natural history includes progressive enlargement and eventual rupture. Computerized tomography, abdominal ultrasonography, or MRI may be used for initial evaluation, but angiography is required to make the definitive diagnosis and for delineation of the vascular anatomy. The lesion should be corrected surgically after the diagnosis is confirmed. Lesions proximal to the gastroduodenal artery may be ligated if there is sufficient collateral flow to the liver. For lesions distal to this artery, surgical resection and reconstruction is required. Selective embolization of intrahepatic or subhepatic aneurysms may be an effective alternative in high-risk patients. We had two cases of aneurysm of the hepatic artery diagnosed at our institution over the course of 18 months. Excellent results were obtained from surgical revascularization of the liver in both cases.