Babu Annu, Rattan Amulya, Singhal Maneesh, Gupta Amit, Kumar Subodh
Division of Trauma Surgery & Critical Care, JPN Apex Trauma Center, Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Chin J Traumatol. 2016 Dec 1;19(6):368-370. doi: 10.1016/j.cjtee.2016.02.003.
Aneurysm of gastroduodenal artery (GDA) is rare. Most reported cases are due to pancreatitis and atherosclerosis; however, those following pancreatic trauma have not been reported. We encoun- tered GDA aneurysm in a patient of blunt abdominal trauma, who had pancreatic contusion and retroduodenal air on contrast enhanced computed tomography of abdomen. Emergency laparotomy for suspected duodenal injury revealed duodenal wall and pancreatic head contusion, mild hemo- peritoneum and no evidence of duodenal perforation. In the postoperative period, the patient developed upper gastrointestinal hemorrhage on day 5. Repeat imaging revealed GDA aneurysm, which was managed successfully by angioembolization. This case highlights, one, delayed presen- tation of GDA aneurysm after blunt pancreatic trauma and two, its successful management using endovascular technique.
胃十二指肠动脉(GDA)动脉瘤较为罕见。大多数报道的病例是由胰腺炎和动脉粥样硬化引起的;然而,胰腺创伤后发生的此类病例尚未见报道。我们遇到一名腹部钝性创伤患者发生了GDA动脉瘤,该患者在腹部增强计算机断层扫描中显示有胰腺挫伤和十二指肠后积气。因怀疑十二指肠损伤而进行的急诊剖腹手术显示十二指肠壁和胰头挫伤、轻度腹腔积血,且无十二指肠穿孔的迹象。术后第5天,患者出现上消化道出血。再次影像学检查发现GDA动脉瘤,通过血管栓塞术成功进行了治疗。该病例突出了两点,一是钝性胰腺创伤后GDA动脉瘤的延迟表现,二是使用血管内技术对其进行的成功治疗。