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腹壁下动脉假性动脉瘤:腹腔镜下腹壁疝修补术的一种罕见并发症。

Pseudoaneurysm of the inferior epigastric artery: a rare complication of laparoscopic ventral hernia repair.

作者信息

Nichols-Totten Kysha, Pollema Travis, Moncure Michael

机构信息

Kansas University School of Medicine, 3838 Rainbow Blvd. 1010 North Kansas Wichita, KS 67214, USA.

出版信息

Surg Laparosc Endosc Percutan Tech. 2012 Feb;22(1):e25-7. doi: 10.1097/SLE.0b013e31823cd8bc.

Abstract

Pseudoaneurysm of the inferior epigastric artery (IEA) is a recognized complication of surgery; however, it is a very rare clinical occurrence. The anatomic position of the IEA subjects patients to possible IEA injury during abdominal wall procedures that are close to the artery, such as insertions of drains, Tenckhoff catheters, laparoscopic trocars, or paracentesis. Treatment options include open surgery, percutaneous coil embolization, embolization with N-butyl cyanoacrylate, sonographic-guided thrombin injection, or sonographic-guided compression. We report the first case of a pseudoaneurysm arising from the IEA after a laparoscopic ventral hernia repair. To our knowledge, 17 IEA pseudoaneurysms have been reported, only 3 of which were spontaneous. The pseudoaneurysm in our patient was successfully treated by percutaneous injection of thrombin by interventional radiology.

摘要

腹壁下动脉假性动脉瘤是一种公认的手术并发症;然而,它在临床上非常罕见。腹壁下动脉的解剖位置使患者在靠近该动脉的腹壁手术(如放置引流管、Tenckhoff导管、腹腔镜套管针或腹腔穿刺术)过程中可能受到腹壁下动脉损伤。治疗选择包括开放手术、经皮弹簧圈栓塞、用N-丁基氰基丙烯酸酯栓塞、超声引导下注射凝血酶或超声引导下压迫。我们报告了首例腹腔镜腹疝修补术后发生的腹壁下动脉假性动脉瘤病例。据我们所知,已有17例腹壁下动脉假性动脉瘤的报道,其中仅3例为自发性。我们患者的假性动脉瘤通过介入放射学经皮注射凝血酶成功治愈。

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