The 93 years Old Patient with Jaundice Caused by a Hepatic Artery Aneurysm. Case Report with Literature Review

Author(s): Podlasek MI, Placzek A, Bielewicz K, Przemyslaw Zan, Podlasek R

The hepatic artery aneurysm (HAA) is a rare cause of cholestasis. The course of HAA, even in 75% of cases is asymptomatic. 14% of cases are complicated by rupture and hemorrhage. Before the development of imaging techniques such as computed tomography or ultrasound, the diagnosis of HAA was stated on the ground of the autopsy or during the laparotomy. Today a detection of an aneurysm is more often earlier, which enables successful treatment. 92.4% of visceral artery aneurysms are diagnosed accidentally during imaging in asymptomatic patients. The patient with an aneurysm of the hepatic artery causing mechanical jaundice, described by us is, to our knowledge, the oldest case report published. The literature review was performed using the database "PubMed" using the keywords "jaundice" and "aneurysm,". To identify additional potentially relevant data sources, we hand-searched the reference lists of the retrieved studies. Reports from 1834 to 2021 concerning mechanical jaundice caused by an aneurysm of visceral arteries were selected. The analysis included studies in which it was possible to determine the procedure, treatment results, and the artery with which the aneurysm was involved. In the reviewed works from 1834 to 2021, 77 cases were described. The oldest case so far was an 89-year-old woman, while the oldest men with this condition were 85 years old. Mechanical jaundice caused by the compression of HAA may occur in patients in their 90-ties and needs endovascular or surgical intervention.