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慢性胰腺炎中的胃十二指肠动脉假性动脉瘤和动脉门静脉瘘

Large gastroduodenal artery pseudoaneurysm and arterioportal fistula in chronic pancreatitis.

作者信息

Cushman Caroline J, Ibrahim Andrew F, Callahan Thomas

机构信息

School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

Department of Interventional Radiology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

出版信息

Radiol Case Rep. 2024 Sep 7;19(12):5612-5618. doi: 10.1016/j.radcr.2024.08.038. eCollection 2024 Dec.

Abstract

Visceral artery pseudoaneurysms, particularly those in the gastroduodenal artery (GDA), are rare but serious complications associated with chronic pancreatitis, posing a significant risk of rupture due to their structural fragility. In this case, a 61-year-old male with a history of chronic pancreatitis, alcohol cirrhosis, duodenal ulcer, and COPD presented with persistent abdominal pain and recurrent fevers. Imaging revealed a 7 cm pseudoaneurysm between the GDA and superior mesenteric vein, which was successfully treated with coil embolization. This case highlights the importance of prompt recognition and intervention in managing GDA pseudoaneurysms, particularly when complicated by an arterioportal fistula, and demonstrates the efficacy of endovascular therapy as a minimally invasive treatment option that can significantly improve patient outcomes in complex vascular complications associated with chronic pancreatitis.

摘要

内脏动脉假性动脉瘤,尤其是胃十二指肠动脉(GDA)的假性动脉瘤,是与慢性胰腺炎相关的罕见但严重的并发症,由于其结构脆弱,破裂风险很大。在本病例中,一名61岁男性,有慢性胰腺炎、酒精性肝硬化、十二指肠溃疡和慢性阻塞性肺疾病病史,出现持续性腹痛和反复发热。影像学检查发现GDA与肠系膜上静脉之间有一个7厘米的假性动脉瘤,通过弹簧圈栓塞成功治疗。该病例强调了在处理GDA假性动脉瘤时及时识别和干预的重要性,特别是当合并动脉门静脉瘘时,并证明了血管内治疗作为一种微创治疗选择的有效性,它可以显著改善与慢性胰腺炎相关的复杂血管并发症患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9586/11406347/f36a68700ae1/gr1.jpg

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