Department of Radiology, Kansai Medical University, Hirakata, Japan.
Jpn J Radiol. 2010 Apr;28(3):239-42. doi: 10.1007/s11604-009-0409-1. Epub 2010 May 1.
A 52-year-old woman was treated for a splenic aneurysm that was found on abdominal computed tomography (CT) during a preoperative assessment for rectal cancer. The aneurysm was embolized using the "double coil-delivered microcatheter technique," and 4 ml of a mixture of N-butyl 2-cyanoacrylate (NBCA) and iodized oil (Lipiodol) (NBCA/Lipiodol = 1.0: 2.5) were injected into the aneurysm. The patient complained of left upper quadrant abdominal pain immediately after the procedure. A blood test 2 days after the procedure showed an increased white blood cell count (13,100/microl), C-reactive protein (13.36 mg/dl), and pancreatic amylase (428 U/l). Abdominal CT scan showed a huge cystic lesion at the pancreatic tail, in the center of which was a highly enhanced area due to accumulated NBCA-Lipiodol. Postembolization pancreatitis was diagnosed, and treatment with fasting and a drip infusion of nafamostat mesilate was started. The patient's abdominal pain became less severe within 3 days, and the pancreatic enzyme level had normalized 14 days after treatment. On CT, the cystic lesion at the pancreatic tail was smaller 20 days after the procedure, and it had disappeared completely 75 days after the procedure.
一位 52 岁女性因直肠癌术前评估时腹部计算机断层扫描（CT）发现脾动脉瘤而接受治疗。该动脉瘤采用“双线圈输送微导管技术”进行栓塞，向动脉瘤内注入 4ml 混合 N-丁基 2-氰基丙烯酸酯（NBCA）和碘化油（Lipiodol）（NBCA/Lipiodol=1.0:2.5）。术后患者立即出现左上腹疼痛。术后 2 天的血液检查显示白细胞计数（13100/μl）、C 反应蛋白（13.36mg/dl）和胰腺淀粉酶（428U/l）升高。腹部 CT 扫描显示胰尾有一个巨大的囊性病变，其中央由于积聚的 NBCA-Lipiodol 而呈现高度增强区域。诊断为栓塞后胰腺炎，并开始禁食和滴注甲磺酸萘莫司他治疗。患者的腹痛在 3 天内减轻，胰腺酶水平在治疗后 14 天恢复正常。CT 显示胰尾的囊性病变在术后 20 天变小，术后 75 天完全消失。
