Hepatic artery aneurysm presenting as abdominal pain and hemoperitoneum

Rupture of a hepatic artery aneurysm is one of the commonest causes of hemoperitoneum, second only to abdominal aortic rupture. The authors illustrate the difficulties of diagnosis and therapy in their description of the case of a 65-year-old man with a ruptured hepatic artery aneurysm. There are no pathognomonic features, and definitive diagnosis requires selective angiography of the hepatic artery. Early intervention by ligation or reconstruction may improve outcome but is associated with a high death rate. Selective embolization under fluoroscopic control may be preferable.