dos Santos Vitorino Modesto, Villaça R B, Almeida A C A, Oliveira E R N C, Nogueira Junior P R M, Damasceno E A M
Catholic University Medical Course.
An Sist Sanit Navar. 2010 May-Aug;33(2):221-5. doi: 10.4321/s1137-66272010000300011.
Hepatic artery aneurysms are scarcely reported, mainly because of non-specific symptoms. More often, they are incidental findings during imaging studies to investigate other acute or chronic abdominal conditions. These aneurysms are usually detected in the sixth decade of life, predominantly among males. We report the case of a 69 year-old female with an unsuspected huge hepatic artery aneurysm associated with ischemic hepatitis. Suspicion of aneurysm arose during imaging studies to clarify the origin of jaundice and abdominal pain. After establishment of the diagnosis, but before open surgery, there was a spontaneous rupture of the aneurysm, which caused hemoperitoneum and death. The necropsy study confirmed ischemic hepatitis. Hepatic artery aneurysms are second among the visceral aneurysms, and may cause abdominal pain, jaundice, and hemorrhagic events. One should suspect abdominal aneurysms in elderly patients with unclear abdominal pain, and this hypothesis should be ruled out by imaging studies.
肝动脉瘤鲜有报道，主要是因为其症状不具特异性。更多时候，它们是在对其他急慢性腹部疾病进行影像学检查时偶然发现的。这些动脉瘤通常在60岁左右被发现，主要见于男性。我们报告一例69岁女性病例，其患有一个未被怀疑的巨大肝动脉瘤，并伴有缺血性肝炎。在进行影像学检查以明确黄疸和腹痛的病因时，怀疑有动脉瘤。确诊后，但在进行开放手术前，动脉瘤发生自发性破裂，导致腹腔积血和死亡。尸检研究证实为缺血性肝炎。肝动脉瘤在内脏动脉瘤中位居第二，可能会引起腹痛、黄疸和出血事件。对于腹痛原因不明的老年患者，应怀疑有腹主动脉瘤，这一假设应通过影像学检查予以排除。
