Reiter Dena A, Fischman Aaron M, Shy Bradley D
Department of Emergency Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA.
J Emerg Med. 2013 Jan;44(1):100-3. doi: 10.1016/j.jemermed.2011.08.021. Epub 2012 Jan 4.
Ruptured hepatic artery pseudoaneurysm, a type of visceral artery aneurysm, is a rare condition that is life threatening if not diagnosed and treated rapidly in the emergency department (ED). Patients presenting with this condition require aggressive resuscitation. Endovascular embolization is the first-line treatment option.
We present a case of spontaneously ruptured hepatic artery pseudoaneurysm and provide a review of the current literature on this topic, focusing on appropriate ED management.
A 41-year-old woman with a history of systemic lupus erythematosus and multiple hepatic bilomas presented to the ED in critical condition with sudden onset of severe abdominal pain and hemodynamic instability. She was found to have a ruptured hepatic artery pseudoaneurysm with marked hemoperitoneum on computed tomography angiography. She was aggressively resuscitated and successfully managed via endovascular embolization.
Ruptured hepatic artery pseudoaneurysm is a life-threatening condition that must be rapidly diagnosed and managed in the ED. Visceral artery aneurysm rupture is a diagnosis that should be considered in any patient presenting to the ED with hemodynamic instability and abdominal pain. Definitive management is with endovascular embolization.
肝动脉假性动脉瘤破裂是内脏动脉瘤的一种，是一种罕见病症，如果在急诊科（ED）未迅速诊断和治疗，会危及生命。出现这种情况的患者需要积极复苏。血管内栓塞是一线治疗选择。
我们报告一例自发性肝动脉假性动脉瘤破裂病例，并对该主题的当前文献进行综述，重点关注急诊科的适当管理。
一名41岁女性，有系统性红斑狼疮病史和多处肝内胆汁瘤，因突发严重腹痛和血流动力学不稳定，以危急状态被送往急诊科。计算机断层血管造影显示她有肝动脉假性动脉瘤破裂并伴有明显的腹腔积血。她接受了积极复苏，并通过血管内栓塞成功治疗。
肝动脉假性动脉瘤破裂是一种危及生命的病症，必须在急诊科迅速诊断和处理。对于任何因血流动力学不稳定和腹痛而到急诊科就诊的患者，都应考虑内脏动脉瘤破裂的诊断。确定性治疗是血管内栓塞。
