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自发性腹腔干夹层导致的无结石性缺血性胆囊炎。

Acalculous Ischemic Cholecystitis Caused by Spontaneous Celiac Artery Dissection.

机构信息

Department of Cardiology, Shimada Municipal Hospital, Japan.

Department of Surgery, Shimada Municipal Hospital, Japan.

出版信息

Intern Med. 2022 Jan 1;61(1):53-58. doi: 10.2169/internalmedicine.7793-21. Epub 2021 Jun 26.

Abstract

We herein report a case of spontaneous isolated dissection of the celiac artery. A Japanese man in his 50s visited an emergency unit, complaining of sudden epigastralgia. Contrast-enhanced computed tomography indicated dissection of the celiac artery with patent false and true lumina, extending to the splenic and common hepatic arteries. On day 3 of hospitalization, the dissection progressed to the proper and right hepatic arteries. Progression of the dissection to the right hepatic artery provoked acalculous ischemic cholecystitis, and cholecystectomy followed. The resected gallbladder revealed extensive aseptic necrosis with little inflammatory reaction, and the gallbladder neck was spared from ischemia.

摘要

我们在此报告一例自发性孤立性腹腔动脉夹层病例。一名 50 多岁的日本男性因突发上腹痛就诊于急诊。增强 CT 显示腹腔动脉夹层,真假腔均通畅,累及脾动脉和肝总动脉。入院第 3 天,夹层向肠系膜上动脉和右肝动脉进展。右肝动脉夹层进展导致胆系无结石性缺血性胆囊炎,并进行了胆囊切除术。切除的胆囊显示广泛无菌性坏死,炎症反应轻微,胆囊颈部未发生缺血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f539/8810253/ae15b8f86f25/1349-7235-61-0053-g001.jpg

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