Open Surgical Management of Celiac Trunk and Hepatic Artery Aneurysms: A Case Series.
Asen Todorov, Margaret Dimova, Ioanna Lineva
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Case in brief
This institutional case series describes three patients with visceral artery aneurysms: two involving the celiac trunk and one involving the hepatic artery. All underwent open repair with reconstruction tailored to anatomy, including splenic artery or superficial femoral artery interposition and aorto-hepato-splenic bypass using great saphenous vein. There was no perioperative mortality. Two patients had major complications: gastric ischemia requiring total gastrectomy and a postoperative hematoma requiring re-exploration. At 1-year follow-up, all grafts were patent and end-organ perfusion was preserved.
What made this case unusual
The series illustrates the potential severity of complications after open repair, including gastric ischemia requiring total gastrectomy, alongside successful graft patency and preserved perfusion at 1 year.
Diagnostic / clinical pearl
For celiac trunk and hepatic artery aneurysms, operative planning should be individualized to preoperative imaging, aneurysm morphology, and comorbidities; open reconstruction can provide patent grafts and preserved end-organ perfusion when selected for the anatomy.