Severe abdominal pain in a Jehovah’s Witness patient

A 76-year-old lady, with past medical history of hypertension, presented to the hospital with complains of severe right upper abdominal pain for 6 days prior to admission. A complete laboratory evaluation was non-revealing. An emergency computed tomography (CT) scan of the abdomen and pelvis revealed a hepatic artery aneurysm measuring 4 x 4 x 6 cm with unstable appearance (Figures 1,2,3). As the patient was a Jehovah’s Witness, and was not going to consent to receive any blood or blood product transfusion if needed, she was taken to the angiography suite emergently where a hepatic artery angiogram was performed. This was followed by embolization with an 8 mm coil, with successful reduction in the size of the aneurysm.

Severe abdominal pain in a Jehovah’s Witness patient