Prosper Ashley, Saremi Farhood
Department of Radiology, University of Southern California, Los Angeles, CA.
Department of Radiology, University of Southern California, Los Angeles, CA.
Ann Vasc Surg. 2016 Oct;36:297.e11-297.e15. doi: 10.1016/j.avsg.2016.04.011. Epub 2016 Jul 15.
This case report demonstrates development and progressive enlargement of multiple pancreaticoduodenal arcade pseudoaneurysms using computed tomography angiographies over a period of 5 weeks after abdominal trauma. The mechanism of pseudoaneurysm formation, as shown by serial imaging, attributed to preexisting celiac axis stenosis by the median arcuate ligament, posttraumatic celiac artery dissection, and secondary occlusion of proper hepatic artery resulting in elevation of pressure and flow in the pancreaticoduodenal arcade and rupture of small arterial branches. Successful pseudoaneurysm occlusion was achieved through arterial embolization.
本病例报告展示了腹部创伤后5周内，通过计算机断层血管造影术观察到的多发性胰十二指肠动脉弓假性动脉瘤的形成及逐渐增大过程。连续成像显示，假性动脉瘤形成的机制归因于正中弓状韧带导致的腹腔干轴狭窄、创伤后腹腔干动脉夹层形成以及肝固有动脉继发闭塞，进而引起胰十二指肠动脉弓内压力和血流升高，导致小动脉分支破裂。通过动脉栓塞成功实现了假性动脉瘤的闭塞。
