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与梅干腹综合征相关的肝动脉瘤:一例病例报告及文献复习

Hepatic artery aneurysm associated with prune belly syndrome: a case report and review of the literature.

作者信息

Alhawsawi Abdulelah M, Aljiffry Murad, Walsh Mark J, Peltekian Kevork, Molinari Michele

机构信息

Department of Surgery, QEII Medical Center, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

J Surg Educ. 2009 Jan-Feb;66(1):43-7. doi: 10.1016/j.jsurg.2008.10.004.

Abstract

Potentially life threatening when they rupture, hepatic artery aneurysms (HAAs) are uncommon and diagnosed at the fifth to sixth decade of life. HAAs are the second most common splanchnic aneurysms after the ones that involve the splenic artery and are more predominant in men than in women with a ratio of 3 to 2. Usually, HAAs are associated with inflammation or traumas to the arteries of the liver. Among the former group, atherosclerosis, arthritis, and collagen vascular disease are the most common, whereas liver biopsy or other radiologic interventions (ie, percutaneous abscess drainage) are frequent iatrogenic causes. HAAs are discovered incidentally in most cases, but some patients can present with intraperitoneal bleeding and hypovolemic shock. The etiology of prune belly syndrome (PBS) is poorly understood, but new evidence suggests that it is caused by mesodermal delay during the fetal development because of an intrauterine injury. We present a case of HAA in a young individual affected by PBS. To our knowledge, this report is the first to describe the existence of these 2 rare conditions in a single patient. We hypothesize that the mesodermal abnormality that involves PBS might be a rare cause of HAA.

摘要

肝动脉动脉瘤(HAA)破裂时可能危及生命,这种动脉瘤并不常见,多在50至60岁时被诊断出来。HAA是仅次于脾动脉瘤的第二常见内脏动脉瘤,男性比女性更易发病,男女比例为3比2。通常,HAA与肝脏动脉的炎症或创伤有关。在前者中,动脉粥样硬化、关节炎和胶原血管病最为常见,而肝活检或其他放射学干预(如经皮脓肿引流)是常见的医源性病因。大多数情况下,HAA是偶然发现的,但有些患者可能会出现腹腔内出血和低血容量性休克。梅干腹综合征(PBS)的病因尚不清楚,但新证据表明,它是由于子宫内损伤导致胎儿发育期间中胚层发育延迟引起的。我们报告一例患有PBS的年轻个体发生HAA的病例。据我们所知,本报告是首次描述这两种罕见病症同时出现在一名患者身上的情况。我们推测,涉及PBS的中胚层异常可能是HAA的罕见病因。

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