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腹腔镜胆囊切除术后右肝动脉假性动脉瘤的放射学诊断与处理:一例报告

Radiological diagnosis and management of postlaparoscopic cholecystectomy right hepatic arterial pseudoaneurysm: A case report.

作者信息

Bhusal Amrit, Jha Saurav Kumar, Oli Rabindra, Paudel Bigyan, Ghimire Pradesh

机构信息

Department of Radio-diagnostics and Imaging, BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Sunsari, Nepal.

Department of Radiology, Chitwan Medical College Teaching Hospital, Chitwan, Nepal.

出版信息

Radiol Case Rep. 2024 Sep 24;19(12):6259-6264. doi: 10.1016/j.radcr.2024.09.005. eCollection 2024 Dec.

Abstract

Injuries to blood vessels occur in 0.8% of the cases following laparoscopic cholecystectomy. They may result from direct penetration while insertion of trocar or by thermal injury (electrocautery). Pseudoaneurysm of hepatic artery is a rare occurrence. It is a serious complication following acute or chronic injuries to hepatic artery, with only 0.06% to 0.6% of the cases being reported. Endovascular embolization is usually the first line treatment in the management of pseudoaneurysm of hepatic artery with high success rate. Surgical intervention should be considered if the embolization fails, pseudoaneurysm are infected or other vascular structures are compressed. Our case highlights a 48-year-old male presenting with complaints of pain abdomen and jaundice later diagnosed to be a case of pseudoaneurysm of right hepatic artery and was successfully managed with angiographic embolization, which is the first line of management.

摘要

腹腔镜胆囊切除术后0.8%的病例会发生血管损伤。其可能因套管针插入时的直接穿刺或热损伤(电灼)所致。肝动脉假性动脉瘤较为罕见。它是肝动脉急性或慢性损伤后的严重并发症,报告病例仅占0.06%至0.6%。血管内栓塞通常是肝动脉假性动脉瘤治疗的一线方法,成功率较高。如果栓塞失败、假性动脉瘤感染或其他血管结构受压,则应考虑手术干预。我们的病例是一名48岁男性,主诉腹痛和黄疸,后来被诊断为右肝动脉假性动脉瘤,并通过血管造影栓塞成功治疗,这是首选的治疗方法。

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