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[Abdominal hemorrhage in multiple intrahepatic aneurysms].
I Husmann1, J Hierholzer, J M Langrehr
1Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Charité Campus Virchow Klinikum, Humboldt Universität zu Berlin.
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|February 28, 2001
Summary
A young male experienced spontaneous hepatic bleeding, likely linked to high-dose aspirin use. Investigations revealed multiple hepatic artery aneurysms, a rare finding without underlying systemic disease.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Internal Medicine
Background:
- Spontaneous hepatic bleeding is rare, often presenting with severe abdominal pain and hemodynamic instability.
- High-dose acetylsalicylic acid (aspirin) use can increase bleeding risk, but its role in spontaneous hepatic artery aneurysm formation is not well-established.
Observation:
- A 17-year-old male presented with acute abdominal pain, anemia, and subhepatic fluid, initially suspected as spontaneous hepatic bleeding.
- Exploratory laparoscopy revealed a large hematoma, but the bleeding source was initially unclear.
- The patient reported daily intake of 2g acetylsalicylic acid for influenza.
Findings:
- Macroscopically unremarkable liver surface, except for a possible cystic artery aneurysm.
- Postoperative angiography confirmed multiple aneurysmal dilatations of both left and right hepatic arteries.
- Extensive workup excluded systemic vasculitis, collagen diseases, or other vascular abnormalities.
Implications:
- This case highlights a potential, albeit rare, association between high-dose aspirin therapy and the development of multiple hepatic artery aneurysms.
- It underscores the importance of thorough vascular imaging in cases of unexplained hepatic bleeding, even in young patients.
- Further research may be warranted to explore the potential pathomechanisms linking aspirin and hepatic artery aneurysm formation.