Krokidis Miltiadis, Hatzidakis Adam, Petrakis John, Lagoudis Theodoros, Tsetis Dimitrios
Department of Radiology, University Hospital of Heraklion, Medical School of Crete, Heraklion, Greece.
Cases J. 2009 Aug 12;2:6562. doi: 10.4076/1757-1626-2-6562.
We report a case of a 71-year old woman with right inferior epigastric artery pseudoaneurysm following laceration by a computed tomography-guided 18G biopsy needle. The laceration was initially treated with placement of retained sutures; however the patient turned hemodynamically unstable 41 days later. Percutaneous ultrasound-guided injection of 1500 U of thrombin solution resulted in almost complete thrombosis of the pseudoaneurysm; however 24 hour control ultrasound revealed refilling of the pseudoaneurysm. Definite treatment was achieved by transcatheter coil embolization. Inferior epigastric artery pseudoaneurysm with underlying laceration may not respond to percutaneous thrombin injection, whereas coil embolization is shown to be effective.
我们报告一例71岁女性,在计算机断层扫描引导下经18G活检针穿刺后出现右腹壁下动脉假性动脉瘤。最初对该穿刺伤采用留置缝线处理;然而,41天后患者出现血流动力学不稳定。经皮超声引导下注射1500 U凝血酶溶液使假性动脉瘤几乎完全血栓形成;但24小时超声复查显示假性动脉瘤再次充盈。最终通过经导管弹簧圈栓塞实现了确定性治疗。腹壁下动脉假性动脉瘤合并潜在穿刺伤可能对经皮凝血酶注射无反应,而弹簧圈栓塞显示有效。