Takase Aya, Akuzawa Nobuhiro, Hatori Takashi, Imai Kunihiko, Kitahara Yonosuke, Aoki Jun, Kurabayashi Masahiko
Department of Internal Medicine, Social Insurance Gunma Chuo General Hospital, Maebashi, Gunma, Japan.
Department of Radiology, Social Insurance Gunma Chuo General Hospital, Maebashi, Gunma, Japan.
Ann Vasc Dis. 2014;7(1):87-92. doi: 10.3400/avd.cr.13-00105. Epub 2014 Feb 4.
Patients with compression of the celiac axis by the median arcuate ligament may develop aneurysms in the pancreaticoduodenal arcades. We experienced two cases of ruptured pancreaticoduodenal artery aneurysm associated with this condition. Both patients presented with abdominal pain and shock, and abdominal contrast-enhanced computed tomography showed retroperitoneal hematoma and compression of the celiac axis by the median arcuate ligament. Both patients were successfully treated by coil embolization. Patients with celiac axis compression or stenosis may develop recurrent aneurysms unless revascularization of the celiac axis is performed. Long-term follow-up is required because aneurysms may develop after 10 years or longer.
正中弓状韧带压迫腹腔干的患者可能会在胰十二指肠动脉弓处形成动脉瘤。我们遇到了两例与这种情况相关的胰十二指肠动脉动脉瘤破裂病例。两名患者均表现为腹痛和休克，腹部增强计算机断层扫描显示腹膜后血肿以及正中弓状韧带对腹腔干的压迫。两名患者均通过弹簧圈栓塞成功治疗。除非对腹腔干进行血运重建，否则腹腔干受压或狭窄的患者可能会出现复发性动脉瘤。需要长期随访，因为动脉瘤可能在10年或更长时间后发生。
