Milot Laurent, Dumortier Jérôme, Boillot Olivier, Pilleul Frank
Imagerie digestive, Hôpital Edouard-Herriot, Lyon.
Gastroenterol Clin Biol. 2007 Mar;31(3):297-9. doi: 10.1016/s0399-8320(07)89377-8.
This case report describes a patient with Hereditary Hemorrhagic Telangiectasia and a giant hepatic artery aneurysm. Aneurysms of the hepatic artery are the second most common form of visceral artery aneurysms. The causes of hepatic artery aneurysms are atherosclerosis in 30% of cases, arteritides, periarterial inflammation, liver transplantation, and hepatic tumor embolization. To our knowledge no giant hepatic artery aneurysm has been described in relation to Weber-Rendu-Osler disease in the literature. These aneurysms probably develop because of hepatic arterio-venous fistulas and secondary to changes in arterial hemodynamics. The increased use of non invasive imaging techniques such as MRI before liver transplantation in patients with hereditary hemorrhagic telangiectasia reveals these asymptomatic aneurysms and makes it possible to choose the best therapeutic approach.
本病例报告描述了一名患有遗传性出血性毛细血管扩张症并伴有巨大肝动脉瘤的患者。肝动脉瘤是内脏动脉瘤的第二常见形式。肝动脉瘤的病因在30%的病例中是动脉粥样硬化,还有动脉炎、动脉周围炎、肝移植以及肝肿瘤栓塞。据我们所知,文献中尚未有与韦-伦-奥氏病相关的巨大肝动脉瘤的描述。这些动脉瘤可能是由于肝动静脉瘘以及动脉血流动力学改变继发形成的。在遗传性出血性毛细血管扩张症患者肝移植前增加使用如MRI等非侵入性成像技术,可发现这些无症状的动脉瘤,并有助于选择最佳治疗方法。