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[创伤后异常右肝动脉假性动脉瘤伴动胆瘘和胆道出血]

[Post-traumatic pseudoaneurysm of an anomalous right hepatic artery with arteriobiliary fistula and hemobilia].

作者信息

Bober J, Vrzgula A, Samek P, Mach P

机构信息

I. chirurgická klinika FNsP, Kosice, Slovenská republika.

出版信息

Rozhl Chir. 1999 Sep;78(9):457-60.

Abstract

The authors describe a rare case of posttraumatic pseudoaneurysm of an anomaly arising right hepatic artery accompanied with arteriobiliary fistula. Treacherousness of this case was given by anomaly origin of the affected vessel. Thirty-four year old female has been treated at the author's department after sustained knife abdominal injury. Before our treatment, she was twice operated at the other hospital for haemoperitoneum and subhepatic abscess with haemobilia. The patient was transferred to the 1st department of surgery in Kosice because of septic shock, right-lobe hepatic abscess and repeated haemobilia. Selective hepatico-mesentericography revealed the cause of haemobilia. At the operation a double ligation of anomaly right hepatic artery was carried out together with closure of arteriobiliary fistula via choledochotomy. Haemobilia was not seen after surgery and the patient was discharged without any signs of liver disfunction. Repeated angiography showed closure of anomaly arising vessel.

摘要

作者描述了一例罕见的创伤后右肝动脉异常假性动脉瘤伴动胆瘘病例。该病例的复杂性在于受累血管的异常起源。一名34岁女性在腹部遭受刀伤后在作者所在科室接受治疗。在我们治疗之前,她曾因腹腔积血、肝下脓肿伴胆道出血在另一家医院接受过两次手术。由于感染性休克、右叶肝脓肿和反复胆道出血,患者被转至科希策第一外科。选择性肝肠系膜造影显示了胆道出血的原因。手术中对异常的右肝动脉进行了双重结扎,并通过胆总管切开术封闭了动胆瘘。术后未见胆道出血,患者出院时无肝功能障碍迹象。重复血管造影显示异常起源血管闭合。

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