PAINLESS OBSTRUCTIVE JAUNDICE IN A CHILD: A RARE CHASE OF HEPATIC ARTERY ANEURYSM

Tenisha Singh [1], Nirav Patel [1], Aluwani Mphahlele [1], Nicola Lahoud [2], John Devar [2]

[1] Department of Pediatric Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, Gauteng, South Africa

[2] Department of Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, Gauteng, South Africa

Abstract

Introduction: Hepatic artery aneurysms are rare visceral aneurysms,predominantly reported in adults, with limited literature in children. Although rare, this condition poses a considerable diagnostic and

therapeutic challenge and is associated with substantial morbidity and

mortality.

Case Presentation: We report on a case of an eleven-year-old boy presenting with painless obstructive jaundice and anemia due to a large hepatic artery aneurysm (HAA). The patient was also found to have sub-

mitral and left common carotid artery aneurysms, with an underlying diagnosis of sarcoidosis. The HAA was managed by surgical ligation. Postoperatively, the patient developed an extrahepatic bile duct stricture

that was managed through external and internal drainage by means of percutaneous transhepatic biliary drainage (PTBD) and endoscopic stenting. Despite these complications, he has shown steady recovery and iscurrently receiving medical treatment for sarcoidosis.

Conclusion: Hepatic artery aneurysm (HAA), though rare, should be considered a potential cause of painless obstructive jaundice in pediatric patients, particularly those with underlying risk factors. Prompt investigation and a multidisciplinary approach are essential to guide individualized treatment, given the risk of rupture and the need to balance immediate and long-term outcomes