Alonso-Lamberti Rizo Laura, Bustamante Recuenco Carlos, Cuesta Pérez Julián, Ramos Rodríguez José Luis, Salazar Carrasco Andrea, Valle Rubio Ainhoa, Jiménez Carneros Virginia, Jiménez Miramón Francisco Javier, Jover Navalón José María
Hospital Universitario de Getafe, Carretera Madrid-Toledo Km 12.5, 28905, Madrid, Spain.
Int J Surg Case Rep. 2020;74:230-233. doi: 10.1016/j.ijscr.2020.08.045. Epub 2020 Aug 29.
Aneurysm of the hepatic artery is most of the time a rare and asymptomatic pathology, but in case of complication it shows high morbidity and mortality requiring in many cases an urgent treatment.
A 92-year-old male presented at the emergency department with high gastrointestinal bleeding and abdominal pain. Gastroscopy showed a submucosal lesion with active bleeding that was controlled through this approach. The study was expanded with a CT angiogram and a complicated hepatic aneurysm with duodenal fistulization was observed.
After reviewing the case, surgical treatment is proposed as the first option but it is rejected by the patient. Thus, aneurysm embolization with coils and thrombin is performed, without further complications.
Selective embolization of the hepatic artery aneurysm is a therapeutic alternative in cases that implies large comorbidities, being an increasingly used technique.
肝动脉瘤多数情况下是一种罕见的无症状病变，但一旦出现并发症，其发病率和死亡率很高，在许多情况下需要紧急治疗。
一名92岁男性因上消化道大出血和腹痛就诊于急诊科。胃镜检查显示一个有活动性出血的黏膜下病变，通过该方法出血得到控制。进一步行CT血管造影检查，发现一个合并十二指肠瘘的复杂肝动脉瘤。
病例回顾后，建议手术治疗作为首选方案，但患者拒绝。因此，采用弹簧圈和凝血酶进行动脉瘤栓塞，未出现进一步并发症。
对于合并多种严重疾病的肝动脉瘤病例，选择性肝动脉栓塞是一种治疗选择，且该技术的应用越来越广泛。
