Ann Ital Chir. 2022 May 12;11:S2239253X22038026.
A 35-year-old woman, chronic alcoholic, was admitted for an attack of acute, necrotizing pancreatitis. Antibiotics and percutaneous drainage failed to control the septic status and the pancreatic collection. Open surgery allowed a successful necrosectomy and drainage. However, a control CT scan before removal of drains showed a 1 cm diameter pseudoaneurysm of the cystic artery, not present at previous abdominal imaging. A redo laparotomy was performed followed by cholecystectomy with en bloc resection of the pseudoaneurysm and a second look of the peripancreatic area. The patient made an uneventful recovery and was discharged on postoperative day 5. Pseudoaneurysms of the cystic artery after acute necrotizing pancreatitis are very rare. Percutaneous embolization is effective in controlling the pseudoaneurysm, but requires subsequent cholecystectomy within a short delay, due to the risk of gangrene of the gallbladder requiring a further, emergency surgical treatment. Open resection of the pseudoaneurysm en bloc with cholecystectomy appears, therefore, an appropriate treatment of this rare condition. KEY WORDS: Cystic artery, Pancreatitis, Pseudoaneurysm.
一位 35 岁的女性慢性酒精中毒患者，因急性坏死性胰腺炎发作入院。抗生素和经皮引流未能控制感染状态和胰腺脓肿。开腹手术成功进行了坏死组织清除和引流。然而，在拔除引流管前的 CT 扫描显示，囊性动脉 1cm 直径假性动脉瘤，在之前的腹部影像学检查中未发现。进行了再次剖腹手术，随后进行了胆囊切除术，整块切除假性动脉瘤，并对胰周区域进行了再次探查。患者术后恢复顺利，术后第 5 天出院。急性坏死性胰腺炎后囊性动脉假性动脉瘤非常罕见。经皮栓塞术可有效控制假性动脉瘤，但由于胆囊坏疽风险，需要在短时间内进行后续胆囊切除术，这需要进一步的紧急手术治疗。因此，连同胆囊切除术整块切除假性动脉瘤似乎是这种罕见情况的一种合适的治疗方法。
囊性动脉、胰腺炎、假性动脉瘤。
