Management of a large hepatic artery aneurysm

We present a rare case of a giant hepatic artery aneurysm in a 61-year-old man that was successfully treated by aneurysmectomy with prosthesis bypass grafting. Because the gastroduodenal artery was occluded, an adequate collateral circulation was not ensured after simple ligation, so a direct arterial flow to the liver was restored to avoid the risk of significant liver or biliary tract ischemia. A computed tomography scan at 1 month showed occlusion of the bypass. The patient remained asymptomatic, despite the supposed lack of adequate collateral circulation. The unpredictable blood supply to the liver is discussed.