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[车祸后胃十二指肠动脉假性动脉瘤破裂的血管内治疗]

[Endovascular Treatment of a Gastroduodenal Artery Pseudoaneurysm Rupture after a Car Accident].

作者信息

Dutra Sofia, Gomes Filipe Veloso, Bilhim Tiago, Coimbra Élia

机构信息

Serviço de Imagiologia. Hospital do Divino Espírito Santo de Ponta Delgada. Açores. Portugal. Unidade de Radiologia de Intervenção. Centro Hepato-Bilio-Pancreático e de Transplantação. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.

Unidade de Radiologia de Intervenção. Centro Hepato-Bilio-Pancreático e de Transplantação. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.

出版信息

Acta Med Port. 2017 Sep 29;30(9):658-661. doi: 10.20344/amp.8561.

Abstract

The authors present a case of a 39-year-old man with alcoholic chronic pancreatitis that was admitted in the emergency department after a car accident, complaining of abdominal pain and looking pale. The patient was hemodinamically unstable, requiring blood transfusions. He underwent computed tomography angiogram of the abdomen and pelvis, showing a pseudoaneurysm of the gastroduodenal artery and a hemoperitoneum. He was referred to our interventional radiology unit and submitted to endovascular treatment, consisting of 'backdoor' and 'frontdoor' embolization of the gastroduodenal artery and pseudoaneurysm neck with coils, with total exclusion in control angiography. With this case description we intend to highlight the rarity of the pseudoaneurysm rupture of the gastroduodenal artery and to emphasize the importance of an interventional radiology response that had a fundamental role in the endovascular treatment, in an emergency context.

摘要

作者报告了一例39岁患有酒精性慢性胰腺炎的男性患者,该患者在车祸后被送往急诊科,主诉腹痛且面色苍白。患者血流动力学不稳定,需要输血。他接受了腹部和盆腔的计算机断层血管造影,显示胃十二指肠动脉假性动脉瘤和腹腔积血。他被转至我们的介入放射科,并接受了血管内治疗,包括用弹簧圈对胃十二指肠动脉和假性动脉瘤颈部进行“后门”和“前门”栓塞,在对照血管造影中实现了完全封堵。通过这个病例描述,我们旨在强调胃十二指肠动脉假性动脉瘤破裂的罕见性,并强调在紧急情况下介入放射科的应对措施在血管内治疗中所起的关键作用。

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