Cirugía General, Hospital Universitario Parc Taulí, España.
Cirugía General, Hospital Universitario Parc Taulí.
Rev Esp Enferm Dig. 2020 Dec;112(12):961-962. doi: 10.17235/reed.2020.7132/2020.
Forty-eight year old man with epigastric pain. CT scan shows a common hepatic artery aneurysm (HAA) of 4,6 cm in size with permeable portal vein. Angiography demonstrates that it affects from the beginning of the celiac trunk until hepatic arteries bifurcation, producing a proximal splenic artery stenosis. Proximal and distal embolization is done achieving a complete aneurysm occlusion. A stent is placed in celiac trunk in order to maintain splenic flow. Permeability of distal hepatic artery through choledochal arteries is observed in a month follow-up CT scan. HAA are infrequent but potentially lethal. Endovascular techniques should be considered of choice currently. HAA embolization has an elevated risk of hepatic ischemia.
一位 48 岁男性，上腹疼痛。CT 扫描显示肝总动脉动脉瘤（HAA）大小为 4.6 厘米，门静脉通透性增加。血管造影显示，它从腹腔干起始处影响到肝动脉分叉处，导致脾动脉近端狭窄。进行近端和远端栓塞以实现完全的动脉瘤闭塞。在腹腔干中放置支架以维持脾血流。一个月后的 CT 扫描观察到胆总管内远端肝动脉的通透性。HAA 虽然不常见，但有潜在致命性。目前，血管内技术应被视为首选。HAA 栓塞有肝缺血的高风险。
