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Volume 66 - 2003 - Fasc.4 - Case reports

Asymptomatic aneurysm of the hepatic artery Management options

Hepatic aneurysms are rare. The majority of patients present acutely with aneurysm rupture, with an attended high mortality. Diagnosis is difficult and often delayed, owing to the non-specific symptoms and lack of clinical findings. We present three cases of hepatic artery aneurysm diagnosed in a pauci- or asymptomatic stage, illustrating the different therapeutic options described when these aneurysms are diagnosed in this stage : expectant manage- ment, embolization, or surgery. (Acta gastroenterol. belg., 2003, 66, 298-302).


Chronic lymphocytic leukemia with portal hypertension and without liver involvement : A case report underlining the roles of increased spleno-portal blood flow and “protective" sinusoidal vasoconstriction

We report the case of a 72-year-old woman with well-controlled chronic lymphocytic leukemia (CLL) and splenomegaly who developed portal hypertension with bleeding oesophageal varices in the absence of liver fibrosis or regenerative nodular hyperplasia at surgical wedge liver biopsy. The hepatic venous pressure gradi- ent (HVPG) was elevated and splenectomy resulted in both its nor- malisation and the regression of oesophageal varices. This case shows the potential for an increased spleno-portal flow to generate severe portal hypertension likely through a "protective" sinusoidal vasoconstriction. (Acta gastroenterol. belg., 2003, 66, 303-306).