Kakizawa Hideaki, Toyota Naoyuki, Hieda Masashi, Ishida Makoto, Takeda Taku, Matsuura Kanji, Hirai Nobuhiko, Tachikake Toshihiro, Matsuura Noriaki, Kohno Shingo, Yananoue Takao, Ito Katsuhide
Department of Radiology, Miyoshi Central Hospital, 531 Higashisakeya, Miyoshi, Hiroshima, 728-8502, Japan.
Radiat Med. 2007 Jul;25(6):295-8. doi: 10.1007/s11604-007-0135-5. Epub 2007 Jul 27.
We report a rare case of mesenteric bleeding following blunt abdominal trauma successfully treated solely with transcatheter arterial embolization (TAE) of the right colic marginal artery. A 56-year-old woman presented with mesenteric bleeding after being involved in a car accident. Computed tomography (CT) showed a large mesenteric hematoma and hemoperitoneum with no associated major injuries to other organs. There was a pseudoaneurysm with extravasation inside the hematoma. TAE was attempted to control bleeding during the preparation for surgical laparotomy. A superior mesenteric angiogram revealed a right colic marginal artery pseudoaneurysm. After successful TAE with microcoils, the affected colon perfusion was preserved via collateral circulation from the ileocolic artery. No ischemic gastrointestinal complications have occurred, and laparotomy has not been necessary during the 6 months after TAE. In isolated mesenteric injury cases, TAE may be a reasonable alternative to emergency laparotomy.
我们报告了一例罕见的钝性腹部创伤后肠系膜出血病例，仅通过右结肠边缘动脉的经导管动脉栓塞术（TAE）就成功治愈。一名56岁女性在车祸后出现肠系膜出血。计算机断层扫描（CT）显示有一个大的肠系膜血肿和腹腔积血，其他器官无相关重大损伤。血肿内有一个伴有外渗的假性动脉瘤。在准备手术剖腹探查期间尝试进行TAE以控制出血。肠系膜上动脉造影显示右结肠边缘动脉假性动脉瘤。在用微线圈成功进行TAE后，通过回结肠动脉的侧支循环保留了受影响结肠的灌注。未发生缺血性胃肠道并发症，在TAE后的6个月内无需进行剖腹手术。在孤立性肠系膜损伤病例中，TAE可能是紧急剖腹手术的合理替代方法。
