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慢性胰腺炎合并动脉门静脉瘘的胰腺动脉假性动脉瘤的血管内治疗:一例报告

Endovascular treatment of a pancreatic artery pseudoaneurysm with arterioportal fistula in chronic pancreatitis: A case report.

作者信息

Yoshida Miki, Mori Kensaku, Shigeta Sakiko, Nagase Masaomi, Ishige Kazunori, Fukuda Kuniaki, Endou Masato, Saida Tsukasa, Nakajima Takahito

机构信息

Department of Diagnostic and Interventional Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan.

Department of Radiology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo 135-8550, Japan.

出版信息

Radiol Case Rep. 2024 Aug 26;19(11):5257-5261. doi: 10.1016/j.radcr.2024.08.009. eCollection 2024 Nov.

Abstract

Arterioportal fistula (APF) combined with a visceral artery pseudoaneurysm is an exceptionally rare and critical vascular disorder of the abdominal viscera, with pseudoaneurysm rupture being potentially fatal and severe APF leading to portal hypertension, both of which necessitate immediate intervention. An 87-year-old woman with a history of pancreatitis presented with upper abdomen and back pain. Laboratory tests revealed elevated amylase levels and severe anemia. A computed tomography (CT) scan showed a large dorsal pancreatic artery (DPA) pseudoaneurysm with a fistula to the main portal vein. Given her advanced age, surgery was deemed high-risk, and endovascular treatment was selected. Transcatheter arterial embolization was successfully performed using coils to embolize the DPA pseudoaneurysm. A follow-up CT 1 week postprocedure confirmed the absence of a pseudoaneurysm and no further progression of anemia.

摘要

动脉门静脉瘘(APF)合并内脏动脉假性动脉瘤是一种极为罕见且严重的腹部内脏血管疾病,假性动脉瘤破裂可能致命,严重的APF会导致门静脉高压,这两种情况都需要立即干预。一名有胰腺炎病史的87岁女性出现上腹部和背部疼痛。实验室检查显示淀粉酶水平升高和严重贫血。计算机断层扫描(CT)显示胰背动脉(DPA)有一个大的假性动脉瘤,并与门静脉主干形成瘘管。鉴于其高龄,手术被认为风险很高,因此选择了血管内治疗。使用线圈成功进行了经导管动脉栓塞术,以栓塞DPA假性动脉瘤。术后1周的随访CT证实假性动脉瘤消失,贫血未进一步加重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe2a/11445591/d770288ceef0/gr1.jpg

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