Bauder M, Fiala A, Klinger C, Kersjes W, Caca K
Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Klinikum Ludwigsburg, Posilipostr. 4, 71640, Ludwigsburg, Deutschland.
Institut für Diagnostische und Interventionelle Radiologie, Klinikum Ludwigsburg, Ludwigsburg, Deutschland.
Internist (Berl). 2018 Feb;59(2):199-204. doi: 10.1007/s00108-017-0293-1.
A 46-year-old woman presented with acute abdominal pain in the right upper quadrant. Esophagogastroduodenoscopy revealed a duodenal stenosis within the horizontal part of the duodenum. Based on the findings of abdominal computed tomography (CT), endosonography, Doppler duplex sonography and angiography, the diagnosis of an aneurysm of a branch of the inferior pancreaticoduodenal artery was established. This arterial branch was part of a collateral circulation between the superior mesenteric artery and the proper hepatic artery caused by obturation of the celiac artery. The symptomatic duodenal stenosis was the result of a local hematoma due to prior rupture of an aneurysm. After successful coiling of the afferent vessels to the aneurysm follow-up examinations showed progredient resorption of the hematoma and the patient was free of complaints.
一名46岁女性因右上腹急性腹痛就诊。食管胃十二指肠镜检查发现十二指肠水平部存在十二指肠狭窄。根据腹部计算机断层扫描(CT)、内镜超声、多普勒双功超声和血管造影的检查结果,确诊为胰十二指肠下动脉分支动脉瘤。该动脉分支是由于腹腔动脉闭塞导致的肠系膜上动脉与肝固有动脉之间侧支循环的一部分。有症状的十二指肠狭窄是动脉瘤先前破裂导致局部血肿的结果。在成功栓塞动脉瘤的供血血管后,随访检查显示血肿逐渐吸收,患者无不适主诉。