Rott Gernot, Boecker Frieder
Radiological Department, Bethesda-Hospital Duisburg, Heerstr. 219, 47053 Duisburg, Germany.
Case Rep Radiol. 2018 Jul 18;2018:4749356. doi: 10.1155/2018/4749356. eCollection 2018.
Segmental arterial mediolysis of an omental artery is an exceptionally rare condition. A 69-year-old man presented with haemoperitoneum six days after being hospitalized due to pneumogenic sepsis. Computed tomography of the abdomen showed a short segment dilatation of an omental artery in the left upper abdomen, compatible with segmental arterial mediolysis. Angiographic examination revealed alterations of omental branches of the right gastroepiploic artery and an aneurysm of the left omental artery, both characteristic of segmental arterial mediolysis. Embolization of the left omental artery with use of N-butyl-2-cyanoacrylate was performed. The postinterventional course was uneventful with increase of haemoglobin levels and without symptoms of omental infarction. Transcatheter embolization in the setting of haemoperitoneum due to segmental arterial mediolysis of an omental branch is technically feasible and a valuable alternative to emergency operation.
网膜动脉节段性动脉中层溶解是一种极为罕见的病症。一名69岁男性因肺炎性脓毒症住院六天后出现腹腔积血。腹部计算机断层扫描显示左上腹网膜动脉有一小段扩张,符合节段性动脉中层溶解表现。血管造影检查发现胃网膜右动脉的网膜分支改变以及左网膜动脉存在动脉瘤,均为节段性动脉中层溶解的特征。使用N-丁基-2-氰基丙烯酸酯对左网膜动脉进行了栓塞。介入治疗后过程顺利,血红蛋白水平升高,且无网膜梗死症状。对于因网膜分支节段性动脉中层溶解导致腹腔积血的情况,经导管栓塞在技术上是可行的,并且是紧急手术的一种有价值的替代方法。