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病例报告:肝动脉假性动脉瘤所致复发性胆道出血,酷似胃肠道出血。

Case report: Recurrent hemobilia due to hepatic artery pseudoaneurysm mimicking gastrointestinal tract bleeding.

作者信息

Wang Jiaoyang, Yang Lei, Xu Lijun, Qin Lijie, Cheng Yanwei

机构信息

Department of Emergency, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China.

出版信息

Front Med (Lausanne). 2023 Jan 9;9:1048763. doi: 10.3389/fmed.2022.1048763. eCollection 2022.

Abstract

Hemobilia, a rare form of upper gastrointestinal bleeding (UGIB), is a potentially fatal complication that usually occurs after iatrogenic hepatobiliary trauma. However, hemobilia is clinically challenging to diagnose and often gets too late to diagnose. We herein report a case of recurrent hemobilia due to hepatic artery pseudoaneurysm (HAP) that was initially misdiagnosed as gastrointestinal tract bleeding. However, the patient was treated successfully with percutaneous coil occlusion of the pseudoaneurysm. This case illustrates that hemobilia can present as a mimic of gastrointestinal tract bleeding, but this is often difficult to diagnose at first glance and often misleads clinicians, especially emergency physicians, into making an incorrect diagnosis. Familiarity with the clinical features of hemobilia can help raise clinical suspicion and facilitate the early diagnosis and treatment of hemobilia.

摘要

胆道出血是上消化道出血(UGIB)的一种罕见形式,是一种潜在的致命并发症,通常发生在医源性肝胆创伤后。然而,胆道出血在临床上诊断具有挑战性,而且常常诊断过晚。我们在此报告一例因肝动脉假性动脉瘤(HAP)导致的复发性胆道出血病例,该病例最初被误诊为胃肠道出血。然而,该患者通过经皮弹簧圈封堵假性动脉瘤获得了成功治疗。该病例表明,胆道出血可能表现为胃肠道出血的假象,但乍一看往往难以诊断,常常误导临床医生,尤其是急诊医生做出错误诊断。熟悉胆道出血的临床特征有助于提高临床怀疑度,并促进胆道出血的早期诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/124d/9870307/81dcc1b76f83/fmed-09-1048763-g001.jpg

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