Haemobilia: secondary to micro aneurysms of hepatic artery

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Pediatric Gastroenterology

Background:

• Intra-abdominal aneurysms are uncommon, with hepatic artery aneurysms being the fourth most frequent site.
• Ruptured hepatic artery aneurysms can present with life-threatening upper gastrointestinal hemorrhage due to hemobilia.

Observation:

• A 5-year-old boy presented with fever, abdominal distension, and unexplained upper GI bleeding.
• Upper GI endoscopy showed normal esophagus and stomach, but blood oozed from the ampulla, indicating hemobilia.

Findings:

• Fluoroscopic-guided angiography identified hepatic artery branches requiring intervention.
• Successful embolization of the affected hepatic artery branches was achieved using 5 metallic coils.

Implications:

• This case highlights the importance of considering hepatic artery aneurysms in pediatric patients with obscure GI bleeding.
• Endovascular embolization is an effective treatment for hepatic artery aneurysms, preventing further hemorrhage.
• Early diagnosis and intervention are crucial for managing this rare but serious condition in children.