Leong B D, Chuah J A, Kumar V M, Mazri M Y, Zainal A A
Department of Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia.
Singapore Med J. 2008 Nov;49(11):e300-2.
True and pseudoaneurysms of the visceral arteries are uncommon. They represent 0.1-0.2 percent of all vascular aneurysms. Visceral artery aneurysms (VAAs) should be treated due to their propensity to rupture and associated high mortality. We describe a 58-year-old man with pseudoaneurysm of the inferior pancreaticoduodenal artery and who presented with post-motor vehicle accident abdominal pain and a pulsatile epigastic mass. Computed tomography (CT) showed a pseudoaneurysm of the visceral artery, and selective mesenteric angiography showed the aneurysm to be arising from the inferior pancreaticoduodenal artery. The aneurysm was successfully treated with endovascular coil embolisation. CT angiogram at one month post-procedure revealed persistent occlusion of the aneurysm. To the best of our knowledge, this is the first reported pseudoaneurysm of inferior pancreaticoduodenal artery secondary to blunt abdominal trauma from a motor vehicle accident and also the first reported VAA from Malaysia.
内脏动脉真性和假性动脉瘤并不常见。它们占所有血管性动脉瘤的0.1% - 0.2%。内脏动脉动脉瘤(VAA)因其易于破裂及相关的高死亡率而应接受治疗。我们描述了一名58岁男性,患有胰十二指肠下动脉假性动脉瘤,他在机动车事故后出现腹痛和上腹部搏动性肿块。计算机断层扫描(CT)显示内脏动脉假性动脉瘤,选择性肠系膜血管造影显示动脉瘤起源于胰十二指肠下动脉。该动脉瘤通过血管内弹簧圈栓塞成功治疗。术后1个月的CT血管造影显示动脉瘤持续闭塞。据我们所知,这是首例因机动车事故钝性腹部创伤继发的胰十二指肠下动脉假性动脉瘤报道,也是马来西亚首例报道的VAA。