Popov Petar, Sagic Dragan, Radovanovic Dragan, Antonic Zelimir, Nenezic Dragoslav, Radak Djordje
Vascular Surgery Clinic, Dedinje Cardiovascular Institute, Belgrade, Serbia.
Vascular. 2008 Jan-Feb;16(1):48-52. doi: 10.2310/6670.2007.00044.
We report a case of successful transcatheter arterial embolization of a pancreaticoduodenal artery pseudoaneurysm (PSA) caused by erosion of the pancreatic pseudocyst content near pancreaticoduodenal arteries. A 55-year-old man was admitted to a local hospital for investigation of severe, stabbing epigastric pain confined to the upper abdomen. He had a history of previous alcohol abuse, chronic pancreatitis, and a duodenal ulcer. Upper gastrointestinal endoscopy revealed narrowing in the pyloric channel along with an ulcer located at the first and second portions of the duodenum with oozing beneath an adherent cloth and duodenal distortion. Computed tomography additionally revealed an enlarged head of the pancreas with numerous spot calcifications and round cystic formation inside, with a diameter of 30 x 25 mm. Following two surgical procedures for duodenal ulcers, selective angiography revealed a PSA located inside the pancreas head and high-grade stenosis > 90% of the celiac trunk and hepatic artery that rose separately from the aorta. Fiber coil embolization was used to occlude the PSA sac successfully. There was no complication after completion of the last embolic procedure. The patient was doing well after 26 months.
我们报告一例成功通过经导管动脉栓塞术治疗由胰十二指肠动脉附近胰腺假性囊肿内容物侵蚀引起的胰十二指肠动脉假性动脉瘤（PSA）的病例。一名55岁男性因局限于上腹部的严重刺痛性上腹痛入住当地医院进行检查。他有既往酗酒、慢性胰腺炎和十二指肠溃疡病史。上消化道内镜检查显示幽门通道狭窄，十二指肠第一和第二部分有溃疡，附着布下有渗血，十二指肠变形。计算机断层扫描还显示胰腺头部增大，有许多斑点状钙化，内部有圆形囊性结构，直径为30×25mm。在进行了两次十二指肠溃疡手术后，选择性血管造影显示一个PSA位于胰头内，腹腔干和肝动脉从主动脉单独发出处有>90%的高度狭窄。使用纤维圈栓塞成功闭塞了PSA囊。最后一次栓塞手术后没有并发症。患者在26个月后情况良好。
