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多排 CT 引导下的脾动脉瘤血管内治疗:一例儿童劈离式肝移植术后、脾动脉结扎起源处的脾动脉瘤。

Multidetector CT-guided endovascular treatment of a splenic artery aneurysm in a child with split-liver transplant and surgically ligated splenic artery origin.

机构信息

Department of Radiology, Mediterranean Institute for Transplantation and Advanced Specialised Therapies, Via Ernesto Tricomi 1, 90127 Palermo, Italy.

出版信息

Pediatr Radiol. 2012 Sep;42(9):1134-7. doi: 10.1007/s00247-012-2355-9. Epub 2012 Mar 9.

Abstract

We report the case of a child who underwent left lateral split-liver transplantation for biliary atresia and surgical ligation of the origin of the splenic artery at the time of the transplantation. Post-transplant portal vein thrombosis was initially treated with a meso-rex shunt. This shunt subsequently thrombosed and was replaced by a splenorenal shunt. Three months after splenorenal shunt placement, US showed a 3.7-cm pseudoaneurysm at the hilum of the spleen. Multidetector CT with 3-D reconstruction allowed precise identification of the pseudoaneurysm feeding artery and therefore helped in planning the interventional radiology procedure, avoiding explorative selective catheterisation. The pseudoaneurysm was successfully treated with endovascular coil embolisation.

摘要

我们报告了一例儿童病例,该患儿因胆道闭锁接受了左外侧分肝移植术,并在移植时结扎了脾动脉的起始部。术后门静脉血栓形成,最初采用间置肠系膜上-下腔静脉分流术治疗。该分流术随后发生血栓形成,改用脾肾分流术。脾肾分流术后 3 个月,超声显示脾门处有一个 3.7 厘米的假性动脉瘤。多排螺旋 CT 三维重建可准确识别假性动脉瘤供血动脉,有助于介入放射学治疗方案的制定,避免了探索性选择性导管插入术。假性动脉瘤经血管内线圈栓塞成功治疗。

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