Haemobilia due to ruptured intrahepatic aneurysm in a child

Area of Science:

• Pediatric Surgery
• Vascular Surgery
• Gastroenterology

Background:

• Intrahepatic artery aneurysms are rare vascular anomalies.
• Aneurysm rupture can lead to significant, life-threatening hemorrhage.
• Pediatric cases of intrahepatic artery aneurysm rupture are exceptionally uncommon.

Observation:

• A 10-year-old child presented with a major, life-threatening gastrointestinal bleed.
• The hemorrhage was attributed to an intraduct rupture of an intrahepatic aneurysm of the right hepatic artery.
• The bleeding onset followed a trauma, potentially contributing to the aneurysm rupture despite a seemingly minor initial injury.

Findings:

• The patient suffered a massive gastrointestinal hemorrhage originating from a ruptured intrahepatic aneurysm.
• Surgical management involved ligation of the right hepatic artery.
• This intervention effectively controlled the severe bleeding.

Implications:

• This case highlights the critical importance of considering vascular anomalies in pediatric gastrointestinal bleeding, even after minor trauma.
• Successful management through arterial ligation demonstrates a viable treatment option for such rare emergencies.
• Further research into the etiology and management of pediatric intrahepatic aneurysms is warranted.