巨大脾动脉瘤破裂入胃，经急诊远端胰腺切除术成功治疗。
Giant splenic artery aneurysm rupture into the stomach that was successfully managed with emergency distal pancreatectomy.
作者信息
Yoshikawa Chihiro, Yamato Ichiro, Nakata Yasuyuki, Nakagawa Tadashi, Inoue Takashi, Nakatani Mitsuhiro, Nezu Daiki, Doi Shunsuke, Kuroda Yasuhiro, Fujii Kazuki, Kishida Shouhei, Kamikubo Midori, Ko Saiho
机构信息
Department of Surgery, Nara Prefecture General Medical Center, 2-897-5 Shichijo-Nishimachi, Nara, 630-8581, Japan.
出版信息
Surg Case Rep. 2022 Aug 2;8(1):148. doi: 10.1186/s40792-022-01498-3.
BACKGROUND
Splenic artery aneurysms usually rupture into the free peritoneal space and rarely into the gastrointestinal tract. We report the case of a patient with a giant splenic artery aneurysm that ruptured in to the stomach with hemorrhagic shock and was successfully treated with emergency surgery.
CASE PRESENTATION
A 59-year-old man presented to the emergency department with chest pain and syncope. Contrast-enhanced computed tomography showed splenic artery aneurysm with active contrast extravasation. He developed upper gastrointestinal (UGI) bleeding and hypovolemic shock. We diagnosed a splenic artery aneurysm ruptured in to the stomach, performed emergency distal splenopancreatectomy including the aneurysm and partial gastric resection, and could prevent patient death.
CONCLUSIONS
This report shows that splenic artery aneurysm can cause UGI bleeding. Thus, clinicians should be alert about this condition when managing patients with UGI bleeding and/or splenic artery aneurysm.
背景
脾动脉瘤通常破裂至游离腹腔，很少破裂至胃肠道。我们报告一例巨大脾动脉瘤破裂入胃并导致失血性休克的患者，经急诊手术成功治疗。
病例介绍
一名59岁男性因胸痛和晕厥就诊于急诊科。增强计算机断层扫描显示脾动脉瘤伴造影剂外渗。他出现上消化道出血和低血容量性休克。我们诊断为脾动脉瘤破裂入胃，实施了包括动脉瘤的急诊远端脾胰切除术和部分胃切除术，成功挽救了患者生命。
结论
本报告表明脾动脉瘤可导致上消化道出血。因此，临床医生在处理上消化道出血和/或脾动脉瘤患者时应警惕这种情况。
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