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

Article Information

Podlasek MI1*, Placzek A2, Bielewicz K2, Przemyslaw Zan2, Podlasek R3

1Department of General, Oncologic and Vascular Surgery, Edward Szczeklik Specialistic Hospital in Tarnow, Poland

2Medical College of Rzeszow University, Poland

3Department of General Surgery, District Hospital in Strzyzów, Poland

*Corresponding author: Podlasek MI, Department of General, Oncologic and Vascular Surgery, Edward Szczeklik Specialistic Hospital, 13 Szpitalna St, Tarnów 33-100, Poland

Received: 13 September 2021; Accepted: 20 September 2021; Published: 28 September 2021

Citation: Podlasek MI, Placzek A, Bielewicz K, Przemysław Zań, Podlasek R. The 93 years Old Patient with Jaundice Caused by a Hepatic Artery Aneurysm. Case Report with Literature Review. Journal of Surgery and Research 4 (2021): 504-516.

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Abstract

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.

Keywords

Jaundice, Aneurysm, Hepatic artery aneurysm, Visceral artery aneurysm

Jaundice articles; Aneurysm articles; Hepatic artery aneurysm articles; Visceral artery aneurysm articles

Article Details

Abbreviations:

VAA Visceral artery aneurysm; HAA Hepatic artery aneurysm; CT Computed Tomography; ERCP Endoscopic Retrograde Cholangiopancreatography; EUS Endoscopic Ultrasound

1. Introduction

The hepatic artery aneurysm (HAA) is a rare cause of cholestasis. There are also publications describing mechanical jaundice caused by the compression of aneurysms originating from other arteries. It is the right and left branch of the hepatic artery, gastroduodenal artery, pancreatoduodenal arteries, celiac trunk, and arc of Buhler as in Table 1. The course of HAA, even in 75% of cases is asymptomatic. 14% of cases are complicated by rupture and hemorrhage [1]. Before the development of imaging techniques such as computed tomography or ultrasound, the diagnosis of VAA was stated on the ground of the autopsy or during the laparotomy [2-4]. Today a detection of an aneurysm is more often earlier, which enables successful treatment [5,6]. 92.4% of VAA are diagnosed accidentally during imaging in asymptomatic patients [7]. The first case of HAA that caused mechanical jaundice was described by Stokes in 1834 [2]. The diagnosis was made based on an autopsy. The first successful treatment was carried out by Kher in 1903 by ligating the HAA [4]. It is assumed that the first preoperative diagnosis through angiography was described by Doppman in 1963 [8]. In contrast, the first description of the embolization of a visceral aneurysm causing mechanical jaundice was published in 1994 [9], although an embolization of aneurysms has been performed since the 1970s. Endovascular, surgical, and alternative methods are used to treat VAA. In endovascular methods, thrombin, vascular adhesives, onyx, or spirals are administered to the aneurysm causing the aneurysm to clot or the stents can be inserted into the artery to cut off the blood supply to the aneurysm and preserve blood flow. Surgical methods are based on: ligation of the vessel with an aneurysm, aneurysmorrhaphy, excision of an aneurysm with anastomosis of the ends of the artery directly or with the use of a prosthesis as well as vein graft. Sometimes it is necessary to ligate vessels with an aneurysm with the formation of a bypass or to remove an aneurysm with a fragment of an organ. [6,10-13] Alternative methods to the above-mentioned are: percutaneous embolization of the aneurysm under ultrasound or CT control and embolization with the usage of EUS [13,14]. Due to the rarity of VAAs, reports on them are limited to case studies and case series [11]. This makes it difficult to determine the best therapeutic path for the choice of technique and timing of intervention [10]. There is no consensus on the optimal treatment of VAA [12]. Endovascular management is the treatment of choice, however, often due to unfavorable morphological conditions of the aneurysm, surgery remains the best or only solution [14]. According to the European Society of Vascular Surgery guidelines from 2017, all symptomatic VAA require repair regardless of their size and location. Asymptomatic patients with VAA <25 mm may be followed up with imaging control every 2-3 years. Invasive treatment should be considered for asymptomatic aneurysms> = 25 mm [15]. The endovascular procedure should be planned first. If it is technically possible and the patient does not present a high perioperative risk, the procedure should be aimed at the reconstruction of the vessel and restoration of blood flow through the vessel. Patients in poor general condition and at high perioperative risk with aneurysms between 2 cm and 5 cm may be observed, but each case should be assessed on an individual basis. Aneurysms larger than 5 cm should be surgically treated [1]. Regardless of the size of the aneurysm, the intervention should be offered to women of childbearing age, planned liver transplant recipients, patients with pancreaticoduodenal, gastroduodenal, or intrahepatic aneurysms. In the case of unstable or uncontrolled hypertension, an aneurysm enlargement, or an arteriovenous fistula, the patient should be qualified for the intervention [1,15]. Visceral Artery Pseudoaneurysms, due to the high risk of perforation, should be provided urgently [14,15]. As reported by Pitton and ca. in a 10-year retrospective single-center analysis on 233 patients - no significant difference in diameter was observed between ruptured and unruptured visceral aneurysms, therefore the author suggests that the qualification should not be based solely on the size [7].

2. Case Presentation

A 93-year-old woman with painless jaundice was admitted to the General Surgery Department. Except for the compensated arterial hypertension, the patient suffered no other significant comorbidities.

The physical examination of the bedridden elderly patient stated no deviation except jaundice.

The laboratory blood tests revealed: elevated total bilirubin level 258,4 umol/L (n. 5.0-21.0 umol/L), higher activity of aminotransferases AST - 318 U/L (n. 0-35 U/L), ALT - 555 U/L (n. 0-35 U/L) and GGTP - 370 U/L (n. 0-38 U/L) with INR 1,20 (n. 0.80 - 1.20). On the ground of ultrasonographic doppler of the abdomen, cholestasis caused by hepatic artery aneurysm was stated.

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Figure 1: Ultrasonographic finding in the hilum of the liver.

The diagnosis was confirmed by CT angiography. The fusiform aneurysm 85 mm x 40 mm was located under the liver and in the hilum. The aneurysm compressing gallbladder and common bile duct consisted of proper hepatic artery aneurysm (24.2 mm diameter and 38.6 mm length) and right hepatic artery aneurysm (36.3 mm diameter and 51.3 mm length). The celiac trunk was absent, splenic artery and left gastric artery arose directly from the abdominal aorta. The common hepatic artery branched from the superior mesenteric artery. Enlargement of the abdominal aorta to 34 mm with an intraluminal thrombus 7 mm thick on a length of 50 mm was also described.

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Figure 2: Proper hepatic artery aneurysm and right hepatic artery aneurysm in CT angiography of the splanchnic vessels.

To restore bile flow ERCP with papillotomy and stent (8.5 F 10 cm) placement inside the common bile duct was performed. The procedure was successful, and reduction of the total bilirubin level to 60.3 umol/l [n. 5.0 - 21.0] was noticed.

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Figure 3: Stent placement during ERCP.

The postoperative course was complicated with upper gastrointestinal bleeding. An Esophagogastroduodenoscopy was performed and a source of the bleeding was found on the posterior wall of the stomach. The hemobilia was excluded and the hemorrhage was stopped with hemostatic clips. There were no other symptoms of gastrointestinal bleeding during hospitalization. Because of the aneurysm's size and anatomy, the patient was disqualified from the endovascular procedure by two vascular surgeons. Open surgery was proposed but the patient didn’t agree to the suggested treatment. She was discharged home with recommended ambulant control and USG of the abdomen in 2 months. The patient died at home a couple of weeks after discharge

3. Discussion

Along with the aging of the population and associated increasing numbers of patients aged over 90, surgeons face the problem of acute intervention in geriatric patients. The data show high perioperative mortality in this age group of 11% in the case of emergency surgery [16]. In line with the above, the treatment of the patient we described was planned in two stages. In the first stage, endoscopic biliary drainage was done. In the second stage, treatment of the aneurysm was planned. After biliary drainage was successful, the vascular procedure could be performed electively. Morphology of aneurysms - size, and vascular anomaly - arising of the hepatic artery from the superior mesenteric artery, high risk of aneurysm dissection, and gastrointestinal bleeding during the procedure were the reasons for the patient's disqualification from endovascular treatment. The patient did not consent to the open surgery, which could cure the underlying disease, however, taking into account the cardiovascular capacity and sickness burden, it could probably accelerate the death. The patient survived hospitalization but died a couple of weeks after discharge. The autopsy was abandoned, therefore the cause of death cannot be determined. Most authors do not follow up, therefore the long-term effects of therapy or the fate of patients after hospitalization are often impossible to determine. If the time of discharge is taken as the cut-off point, as in most publications, the patient survived. Three similar cases have been reported in the literature. Due to the lack of consent to the vascular procedure, the intervention in the patient described by Julianow was also limited to ERCP with a biliary stent. After 12 months, a follow-up was performed, the patient did not present any complaints. The originally described HAA was 64 mm in diameter [17]. The patient presented by Rathiel was disqualified from the vascular procedure due to cardiovascular insufficiency, while endovascular embolization was abandoned due to concerns about extensive ischemia of the treated area [18]. There is no information regarding the patient's fate after the discharge. The patient presented by Peter did not make it to the procedure scheduled for the next day. Death was due to massive hemorrhage [19]. The literature review was performed using the database "Pub Med" 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. The literature review is summarized in Table 1 and Table 2. The conservative treatment or surgery without vascular procedure in the case of VAA complicated by jaundice almost always resulted in the patient's death. In 28 cases only 1 survival was recorded. The only case with a patient's survival was described by McEwan-Alvarado. There is no information about follow-up [8]. ERCP without other procedures was performed in 4 patients, 3 of them were discharged, and one died during hospitalization. The endovascular treatment was used in 28 cases, in 10 cases it was preceded by ERCP. There was no mortality after endovascular treatment. Ten patients required vascular surgery after an intravascular treatment. In the case of the surgical vascular procedure 5 patients out of 28 died.

Table icon

Table 1: Literature review

Abbreviations: HA Hepatic artery; RHA right hepatic artery; LHA left hepatic artery; GDA gastroduodenal artery; PCDA pancreatoduodenal artery; CA celiac axis; SMA superior mesenteric artery; PSA pseudoaneurysm; ERCP Endoscopic Retrograde Cholangiopancreatography; PTC Percutaneous transhepatic cholangiography; TAE transcatheter arterial embolization.

Treatment

Cases

Deaths

Conservative treatment, surgery without vascular procedure

28

27

Surgery with vascular procedure

17

3

ERCP

4

1

Endovascular procedure

11

0

ERCP + Endovascular procedure

7

0

ERCP + Surgery with vascular procedure

1

0

ERCP + Endovascular procedure + Surgery with vascular procedure

3

1

Endovascular procedure + Surgery with vascular procedure

7

1

Table 2: Treatment procedure

4. Conclusion

Jaundice due to HAA can be observed in patients over 90 years of age, so this possibility should be taken into account in the differential diagnosis. VAA with jaundice requires an endovascular or surgical intervention. In hemodynamically stable cases ERCP with biliary stenting can be performed before causative endovascular or surgical treatment, to prepare the patient for further treatment. ERCP with biliary stenting can also be performed in the absence of the patient's consent to the vascular procedure to protect the liver function.

Funding:

None

Conflict of interest:

None declared

Ethical Approval:

Not required

References

  1. Abbas MA, Fowl RJ, Stone WM, et al. Hepatic artery aneurysm: factors that predict complications. Journal of vascular surgery 38 (2003): 41-45.
  2. Stokes W. Researches on the diagnosis and pathology of aneurism. The Dublin Journal of Medical and Chemical Science 5 (1834): 400-440 .
  3. Wallmann H. Aneurysma der Arteria hepatica. Archiv für pathologische anatomie und physiologie und für Klinische Medicin 14 (1858): 389-392.
  4. Kher H. Der erste Fall von erfolgreicher Unterbindung der Art. hepatica propria wegen Aneurysma. Muenchener Medizinische Wochenschrift 50 (1903): 1861-1867.
  5. Mazziotti S, Blandino A, Gaeta M, et al. Hepatic artery aneurysm, an unusual cause of obstructive jaundice: MR cholangiography findings. Abdominal imaging 28 (2003): 835-837.
  6. Sojka M, Jargiello T, Wolski A, et al. Treatment of visceral and renal aneurysms with endovascular methods. Polish Postepy Nauk Medycznych (2012)
  7. Pitton MB, Dappa E, Jungmann F, et al. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade. European radiology 25 (2015): 2004-2014.
  8. McEwan-Alvarado G, Villarreal HR, Broders AC, et al. Aneurysm of the hepatic artery. An unusual cause of obstructive jaundice. The American journal of digestive diseases 12 (1967): 509-514.
  9. Blomley MJ, Jackson JE. Case report: a gastroduodenal artery pseudoaneurysm presenting with obstructive jaundice and treated by arterial embolization. Clin Radiol 49 (1994): 715-718.
  10. Wojtaszek M. Managing visceral artery aneurysms. Endovascular today 10 (2013): 77-81.
  11. Obara H, Kentaro M, Inoue M, et al. Current management strategies for visceral artery aneurysms: An overview. Surgery today 50 (2020): 38-49.
  12. Cordova AC, Sumpio BE. Visceral Artery Aneurysms and Pseudoaneurysms- Should they all be managed by endovascular techniques?. Annals of vascular diseases 6 (2013): 687-693.
  13. Venturini M, Piacentino F, Coppola A, et al. Visceral Artery Aneurysms Embolization and Other Interventional Options: State of the Art and New Perspectives. Journal of clinical medicine 10 (2021): 2520.
  14. Sousa J, Costa D, Mansilha A. Visceral artery aneurysms: review on indications and current treatment strategies. International angiology : a journal of the International Union of Angiology 38 (2019): 381-394.
  15. Björck M, Koelemay M, Acosta S, et al. Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery 53 (2017): 460-510.
  16. Turrentine FE, Wang H, Simpson VB, et al. Surgical risk factors, morbidity, and mortality in elderly patients. Journal of the American College of Surgeons 203 (2006): 865-877.
  17. Julianov A, Georgiev Y. Hepatic artery aneurysm causing obstructive jaundice. Quantitative imaging in medicine and surgery 4 (2014): 294-295.
  18. Raithel M, Ganzleben I, Gschossmann J, et al. A true vascular aneurysm of the hepatic artery proper as a rare cause of nonmalignant painless jaundice. Endoscopy 46 (2014): E652-E653.
  19. Peter G, Shaheer R, Narayanan P, et al. Hepatic artery aneurysm: a rare case of obstructive jaundice with severe hemobilia. Annals of gastroenterology 27 (2014): 288-289.
  20. Jackson JBS. Aneurism of the hepatic artery bursting into the hepatic duct. Medical Magazine Boston 3 (1935): 115-117.
  21. Rolland W. Aneurysm of the Hepatic Artery: Clinical and pathological notes of a case, with a review of the previously recorded cases. Glasgow medical journal 69 (1908) 342-358.
  22. Quincke H. Ein Fall von Aneurysma der Leberarterie. Berliner Klinische Wochenschrift 8 (1871): 349-352.
  23. White WH. Cases of Jaundice due to Aneurysm of the Hepatic Artery and to Movable Kidney. British medical journal 1 (1892): 223-224.  
  24. Campbell W. Clinical Notes on a Case of hepatic aneurysm with analysis of symptoms, with diagnosis, pathology, etc of This Disease. MD thesis, University of Glasgow (1911).
  25. Dean G, Falconer AW. Aneurysm of the Hepatic Artery. Edinburgh Medical Journal 8 (1912): 124-131.
  26. Taylor EH. Ruptured Aneurysm of the Hepatic Artery. New England Journal of Medicine 208 (1933): 644-646.
  27. Malloy HR, Jason RS. Aneurysm of the hepatic artery, The American Journal of Surgery 57 (1942): 359-363.
  28. Gordon-Taylor G. Rare Cause of Severe Gastro-intestinal Haemorrhage. British medical journal 1 (1943): 504-505.
  29. McNamaraWL, Baker LA, Costich K. Aneurysm of Hepatic Artery. Annals of surgery 123 (1946): 427-435.
  30. Sampsel JW, Barry FM, Steele HD. Aneurysm of an anomalous pancreaticoduodenal artery; case report and review of the literature. Archives of surgery 64 (1952): 74-79.
  31. Quattlebaum JK. Aneurysm of the hepatic artery: report of three cases. Annals of surgery 139 (1954): 743-750.
  32. Tetreault AF, Bowen JR, SAMPAIO N. Hemobilia secondary to intrahepatic aneurysm of the hepatic artery: report of a case with clinical and pathological correlations. JAMA 192 (1965): 1096-1098.
  33. Collier RL, Fox TA. Aneurysm of the hepatic artery as an unusual cause of obstructive jaundice. Henry Ford Hospital medical journal 14 (1966): 421-427.
  34. Mehnert PJ, Freeman LM. (1971). Obstructive jaundice caused by hepatic artery aneurysm demonstration by radionuclide imaging techniques. Journal of nuclear medicine: official publication. Society of Nuclear Medicine 12 (1971): 761-762.
  35. Yin T, Wan Z, Chen H, et al. Obstructive jaundice caused by pancreaticoduodenal artery aneurysms associated with celiac axis stenosis: case report and review of the literature. Annals of vascular surgery 29 (2015): 1016.e1–1016.e10166.
  36. Scheflan M, Kadir S, Athanasoulis CA, et al. Pancreaticoduodenal artery aneurysm simulating carcinoma of the head of the pancreas. Archives of surgery 112 (1977): 1201-1203.
  37. Harlaftis NN, Akin JT. Hemobilia from ruptured hepatic artery aneurysm. Report of a case and review of the literature. American journal of surgery 133 (1977): 229-232.
  38. Mojab K, Lim LT, Esfahani F, et al. Mycotic aneurysm of the hepatic artery causing obstructive jaundice. AJR. American journal of roentgenology 128 (1977): 143-144.
  39. Kadir S, Athanasoulis CA, Yune HY, et al. Aneurysms of the pancreaticoduodenal arteries in association with celiac axis occlusion. Cardiovascular radiology 1 (1978): 173-177.
  40. Lewis DR, Jr Kung H, Connon JJ. Biliary obstruction secondary to hepatic artery aneurysm: cholangiographic appearance and diagnostic considerations. Gastroenterology 82 (1982): 1446-1451.
  41. Green D, Carroll BA. Aneurysm of the gastroduodenal artery causing biliary obstruction: real-time ultrasound diagnosis. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 3 (1984): 375-377.
  42. Bret PM, Partensky C, Bretagnolle M, et al. Obstructive jaundice by a dissecting aneurysm of celiac axis and hepatic artery. Digestive diseases and sciences 32 (1987): 1431-1434.
  43. Griffith JF, Bera SK, Loft DE. A case of obstructive jaundice. The British journal of radiology 70 (1997): 107-108.
  44. Widjaja A, Rosenthal H, Bleck J, et al. Pitfall: a pseudo tumor within the left liver lobe presenting with abdominal pain, jaundice and severe weight loss. Ultraschall in der Medizin 20 (1999): 268-272.
  45. O'Driscoll D, Olliff SP, Olliff JF. Hepatic artery aneurysm. The British journal of radiology 72 (1999): 1018-1025.
  46. Chandramohan, Khan AN, Fitzgerald S, et al. Sonographic diagnosis and follow-up of idiopathic hepatic artery aneurysm, an unusual cause of obstructive jaundice. Journal of clinical ultrasound 29 (2001): 466-471.
  47. Ryan MF, Murphy JP, Benjaminov O. Hemobilia due to idiopathic hepatic artery aneurysm: case report. Canadian Association of Radiologists journal Journal l'Association canadienne des radiologistes 53 (2002): 149-152.
  48. Bramis J, Felekouras E, Kontos M, et al. True giant common hepatic artery aneurysm associated with obstructive jaundice: a case report. International surgery 87 (2002): 142-146.
  49. Akatsu T, Hayashi S, Egawa T, et al. Hepatic artery pseudoaneurysm associated with cholecystitis that ruptured into the gallbladder. Journal of gastroenterology 39 (2004): 900-903.
  50. Dönmez H, Men S, Dilli A, et al. Giant gastroduodenal artery pseudoaneurysm due to polyarteritis nodosa as a cause of obstructive jaundice: imaging findings and coil embolization results. Cardiovascular and interventional radiology 28 (2005): 850-853.
  51. Tsitouridis I, Tsinoglou K, Papastergiou C, et al. Giant hepatic artery aneurysm as a rare cause of obstructive jaundice: Radiological evaluation, European Journal of Radiology 58 (2006): 9-12
  52. Aoufi S, Herrera Justiniano JM, García-Agudo R, et al. Una causa infrecuente de ictericia obstructiva: aneurisma de la arteria gastroduodenal de grandes dimensiones [An unusual cause of obstructive jaundice: giant gastroduodenal artery aneurysm]. Gastroenterologia y hepatologia 30 (2007): 114-116.
  53. Parmar H, Shah J, Shah B, et al. Imaging findings in a giant hepatic artery aneurysm. Journal of postgraduate medicine 46 (2000): 104-105.
  54. Colak MC, Kocaturk H, Bayram E et al. Inferior pancreaticoduodenal artery false aneurysm: a rare cause of gastrointestinal bleeding diagnosed by three-dimensional computed tomography. Singapore medical journal 50 (2009): e346-e349.
  55. Witczak A, Modzelewski B. Hemobilia spowodowana peknieciem tetniaka tetnicy watrobowej--opis przypadku [Hemobilia caused by ruptured hepatic artery aneurysm--case report]. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego 27 (2009): 481-483.
  56. Bronstein J, Cohen J, Sehgal S, et al. Hepatic artery aneurysm: an unusual case of biliary obstruction. Vascular medicine (London, England) 15 (2010): 75-77.
  57. Bennett J, Fay D, Krysztopik R. Right hepatic artery false aneurysm secondary to acalculous cholecystitis. BMJ case reports 11 (2010): bcr0820103258.
  58. Jayia P, Hosney S, Subramanian A, et al. (2011). Arc of Buhler aneurysm: a rare cause of obstructive jaundice. Vascular and endovascular surgery 45 (2011): 92.
  59. Ramirez-Maldonado R, Ramos E, Dominguez J, et al. Pseudoaneurysm of the right hepatic artery and bile duct necrosis as a complication of acute cholecystitis in a diabetic patient. Journal of surgical case reports 3 (2011): 4.
  60. Bach AG, Abbas J, Schramm D, et al. (2012). An unusual cause of jaundice. The American journal of medicine 125 (2012): e7-e8.
  61. Noor MT, Dutta U, Appasani S, et al. Hepatic artery aneurysm: a rare presentation as cholangitis and portal hypertension. Gastrointestinal endoscopy 75 (2012): 190-191.
  62. Shiraishi M, Takahashi M, Yamaguchi A, et al. Hepatic artery pseudoaneurysm with extrahepatic biliary obstruction. Annals of vascular diseases 5 (2012): 100-103.
  63. Wattez H, Lancelevée J, Perot C, et al. Compressive pancreaticoduodenal artery aneurysm associated with celiac artery stenosis. Annals of vascular surgery 27 (2013): 1187.e1-1187.e11874.
  64. Morris ME, Jones RG, Walker SK, et al. Obstructive jaundice secondary to multiple hepatic artery aneurysms in a 14-year-old boy with neurofibromatosis type 1. Annals of vascular surgery 27 (2013): 673.e1-673.e6734.
  65. Hsiao CY, Kuo TC, Lai HS, et al. Obstructive jaundice as a complication of a right hepatic artery pseudoaneurysm after laparoscopic cholecystectomy. Journal of minimal access surgery 11 (2015): 163-164.
  66. Abdalla S, Thome A, Reslinger V, et al. Compressive hematoma due to pseudoaneurysm of the right hepatic artery: A rare cause of obstructive jaundice after single-port cholecystectomy. Surgical laparoscopy, endoscopy & percutaneous techniques 25 (2015): e42-e44.
  67. Yen YT, Lai HW, Lin CH. Endovascular salvage for contained rupture of gastroduodenal artery aneurysm presented with obstructive jaundice. Annals of vascular surgery 29 (2015): 1017.e1-1017.e10175.
  68. Luckhurst CM, Perez C, Collinsworth AL, et al. Atypical presentation of a hepatic artery pseudoaneurysm: A case report and review of the literature. World journal of hepatology 8 (2016): 779-784.
  69. Wyzgowski P, Grzela T, Przybyl M, et al. Rare case of hepatic artery pseudoaneurysm. Polski przeglad chirurgiczny 88 (2016): 163-165.
  70. Gallego Otaegui L, Sainz Lete A, Gutiérrez Ríos RD, et al. Obstructive jaundice caused by a pancreaticoduodenal pseudoaneurysm. Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva 108 (2016): 366-367.
  71. Vultaggio F, Morère PH, Constantin C, et al. Gastrointestinal bleeding and obstructive jaundice: Think of hepatic artery aneurysm. World journal of gastrointestinal surgery 8 (2016): 467-471.
  72. Linzay C, Seth A, Suryawala K, et al. The Aftermath of a Hepatic Artery Aneurysm-A Rare Etiology of Biliary Obstruction!. Clinical medicine insights. Gastroenterology 12 (2017): 11-15
  73. Roberto M, Meytes V, Liu S. Ruptured hepatic aneurysm as first presenting symptom of polyarteritis nodosa. Oxford medical case reports 20 (2018): 12-18
  74. Das M, Volmar FH, Walayat S, et al. (2019). Hemobilia from a right hepatic artery pseudoaneurysm due to chronic cholecystitis. SAGE open medical case reports 7 (2019): 56-68
  75. Chapman BM, Bolton JS, Gioe SM et al. Gastroduodenal artery pseudoaneurysm causing obstructive jaundice. The Ochsner journal 21 (2021): 104-107.

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