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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Related Experiment Video

Updated: May 6, 2026

Re-Arterialized Rat Partial Liver Transplantation with an in vivo Vessel-Oriented 70% Hepatectomy
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Hepatic artery aneurysm developing after Billroth's operation.

Nikola Fatic1, Davor Music1, Nenad Zornic2

  • 1Clinical Centre of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro.

Annals of Vascular Surgery
|November 5, 2013
PubMed
Summary

A rare common hepatic artery aneurysm developed 30 years post-Billroth II surgery. Extensive adhesions likely caused arterial wall stretching, leading to the aneurysm formation.

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Area of Science:

  • Gastroenterology and Hepatobiliary Surgery
  • Vascular Surgery

Background:

  • Billroth's II gastrojejunostomy is a common surgical procedure for peptic ulcer disease.
  • Hepatic artery aneurysms are rare but serious complications, often associated with surgical history.

Observation:

  • A 65-year-old male presented with epigastric pain and weight loss 30 years after a Billroth II resection.
  • Computed tomography identified a 35 mm common hepatic artery aneurysm (HAA).
  • Intraoperative findings revealed extensive adhesions involving the hepatoduodenal ligament and transverse mesocolon.

Findings:

  • The HAA was successfully treated with aneurysmectomy and prosthetic bypass.
  • Intraoperative adhesions were noted to be tightly affixed to the arterial wall and surrounding structures.
  • Progressive stretching and thinning of the arterial wall due to adhesions is the proposed etiology for HAA.

Implications:

  • This case highlights the potential for delayed complications following Billroth II surgery.
  • Understanding the role of adhesions in aneurysm development is crucial for surgical planning and patient monitoring.
  • Long-term surveillance may be warranted in patients with a history of abdominal surgery and associated adhesions.