Serena Thomas J, Antypas Elias, Malay Naveen, Laveroni Eugene
General Surgery/Vascular Surgery, Beaumont Health, Livonia, USA.
Radiology, Beaumont Health, Farmington Hills, USA.
Cureus. 2020 Apr 23;12(4):e7802. doi: 10.7759/cureus.7802.
Hepatic artery aneurysms have an estimated incidence of approximately 0.002%, of which one half are pseudoaneurysms (PsAs). These typically occur following trauma or liver transplant and are often asymptomatic. An uncommon pathology, mycotic aneurysms or PsAs are those that result as a consequence of infections. The danger in mycotic processes stems from their complications of systemic seeding of infection, rupture, and possible exsanguination. This case reports a mycotic PsA that was found in an accessory left hepatic artery (aLHA) branching from the left gastric artery (LGA). The patient presented with recurrent Clostridium difficile colitis with perforation and was later found to have a left upper quadrant vascular lesion during repeat imaging after failing to progress in their clinical course. After multidisciplinary meetings with vascular surgery and interventional radiology, the patient eventually underwent endovascular coil embolization. This is the first documented case of a mycotic PsA secondary to recurrent C. difficile colitis located in an aLHA branching from the LGA.
肝动脉瘤的估计发病率约为0.002%，其中一半为假性动脉瘤（PsA）。这些通常发生在创伤或肝移植后，且往往无症状。真菌性动脉瘤或PsA是一种不常见的病理类型，是由感染引起的。真菌性病变的危险源于其感染全身播散、破裂以及可能导致出血的并发症。本病例报告了一例在源自胃左动脉（LGA）的副肝左动脉（aLHA）中发现的真菌性PsA。该患者表现为复发性艰难梭菌结肠炎伴穿孔，在临床病程无进展后进行重复影像学检查时，后来发现左上腹有血管病变。在与血管外科和介入放射学进行多学科会诊后，该患者最终接受了血管内弹簧圈栓塞术。这是首例记录在案的继发于复发性艰难梭菌结肠炎的真菌性PsA病例，该PsA位于源自LGA的aLHA中。
