Hepatic artery aneurysm: a pitfall in biliary surgery.

This paper describes a patient operated upon for gall-bladder and bile duct stones, who presented with an extrahepatic aneurysm of the main hepatic arterial trunk and with a central intrahepatic haematoma assumed to be caused by the rupture of an intrahepatic aneurysm or by secondary intrahepatic necrosis. Exploration of the bile ducts resulted in haemobilia. The presence of extrahepatic arterial collaterals precluded individualization of the left and right hepatic arteries and subsequent distal arterial ligation or partial hepatectomy. Ligation of the common hepatic artery, although initially successful, was insufficient to avoid a recurrent and fatal haemobilia.