Surgical treatment of a huge hepatic artery aneurysm--a case report.

A debilitated 68 year old woman with an epigastric mass previously identified as a hepatic artery aneurysm (HAA) by selective angiography, developed acute epigastric pain radiating to her back. Impending rupture was diagnosed, and the patient successfully underwent surgical repair using a prosthetic patch to close the orifice of the aneurysm. HAA is uncommon, but the risk of rupture is great, being 44 per cent and the mortality rate high, being 35 per cent. Abnormal ultrasonography and CT may suggest the diagnosis, but selective arteriography is definitive. Surgical treatment is indicated in most patients, although embolization is appropriate for intrahepatic aneurysm and extremely poor risk patients.