Hepatic- and Celiac-Artery Aneurysms

ANEURYSMS of the hepatic and celiac arteries are both unusual and lethal. The total number of reports in the United States and European literature is 143 and 38, respectively.^1-20 Of the 37 cases treated surgically, excision of the aneurysm was successful in only a dozen. At the present time there is no doubt as to the necessity of surgical intervention in hepatic and celiac aneurysms. Eighty percent or more will rupture into the peritoneal cavity, bile ducts,¹¹ gallbladder, duodenum, or stomach.¹⁷ One case has been reported in which the aneurysm ruptured into the portal veins, producing esophageal varices and death due to hemorrhage.⁶ Few incidental aneurysms have been reported at autopsy, and we have found only one case in which an arteriosclerotic hepatic aneurysm noted at surgery has been followed for four years and has remained asymptomatic.¹⁹ The lethal nature of the celiac-artery aneurysm is obvious,