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原发性脾动脉瘤导管内破裂继发胰管出血:经内镜逆行胰胆管造影(ERCP)诊断及介入放射学成功治疗

Hemosuccus pancreaticus secondary to intraductal rupture of a primary splenic artery aneurysm: diagnosis by ERCP and successful management by interventional radiology.

作者信息

Hasaj O, Di Stasi C, Perri V, Tringali A, Costamagna G

机构信息

Digestive Endoscopy Unit, Sacred Heart Catholic University A Gemelli University Hospital, Italy.

出版信息

Endoscopy. 2004 May;36(5):437-41. doi: 10.1055/s-2004-814417.

Abstract

This report describes the case of a 65-year-old man with a prolonged history of gastrointestinal bleeding of unknown origin. During a 2-year period, he underwent 28 endoscopic procedures, three angiographies with or without heparin provocation, a nuclear scan, and abdominal magnetic resonance imaging, none of which were diagnostic. A blind ileocecal resection was also carried out. A diagnosis of hemosuccus pancreaticus secondary to a ruptured primary splenic artery aneurysm was obtained by endoscopic retrograde cholangiopancreatography, and successful interventional radiographic embolization of the splenic artery aneurysm was conducted. During a 17-month follow-up period, no relapse of gastrointestinal bleeding was observed.

摘要

本报告描述了一名65岁男性患者的病例,该患者有长期不明原因的胃肠道出血病史。在两年时间里,他接受了28次内镜检查、三次使用或不使用肝素激发试验的血管造影、一次核扫描以及腹部磁共振成像检查,但均未得出诊断结果。还进行了盲肠切除术。通过内镜逆行胰胆管造影术诊断为原发性脾动脉瘤破裂继发胰管出血,并成功地对脾动脉瘤进行了介入放射栓塞治疗。在17个月的随访期内,未观察到胃肠道出血复发。

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