Department of Pathology, Changde Hospital, Xiangya School of Medicine, Central South University, (The First People's Hospital of Changde City), Changde 415003, China.
Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University, (The First People's Hospital of Changde City), Changde 415003, China.
Curr Med Imaging. 2024;20:e15734056341816. doi: 10.2174/0115734056341816240829060516.
Transcatheter radiofrequency ablation is one of the main treatments for atrial fibrillation, but related complications of this surgery are uncommon.
Here, we report a 70-year-old elderly male patient with atrial fibrillation who experienced severe abdominal pain early after undergoing radiofrequency ablation; related imaging examinations suggested that the patient had intestinal edema and thickening, combined with hepatic portal vein gas accumulation. The reason was that the patient experienced intestinal necrosis due to superior mesenteric artery embolism related to radiofrequency surgery. The surgeon suggested laparotomy for exploration. However, after multidisciplinary consideration, we ultimately chose conservative treatment. After fasting, gastrointestinal decompression, spasmolysis, pain relief, somatostatin inhibition of intestinal edema, antiinfection, and anticoagulation, the patient's condition improved, and he was discharged. We followed the patient for 1 month after discharge, and there was no special discomfort.
Hepatoportal vein gas accumulation after radiofrequency ablation of atrial fibrillation is rare, and imaging findings have important guiding significance for the diagnosis and treatment of the disease.
经导管射频消融是治疗心房颤动的主要方法之一，但该手术相关并发症并不常见。
本文报道了 1 例 70 岁老年男性患者，在射频消融术后早期出现严重腹痛；相关影像学检查提示患者存在肠壁水肿、增厚，合并肝门静脉积气。其病因考虑为与射频手术相关的肠系膜上动脉栓塞导致肠坏死。外科医生建议剖腹探查。但经多学科讨论后，我们最终选择了保守治疗。予禁食、胃肠减压、解痉止痛、生长抑素抑制肠壁水肿、抗感染、抗凝等治疗后，患者病情好转出院。出院后随访 1 个月，患者无特殊不适。
心房颤动射频消融术后发生肝门静脉积气较为罕见，影像学表现对疾病的诊断和治疗具有重要的指导意义。
