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IgG4相关性硬化性胆管炎治疗期间的多发肝内动脉瘤：一例报告

Multiple intrahepatic artery aneurysms during the treatment for IgG4-related sclerosing cholangitis: A case report.

作者信息

Tamura Hotaka, Ozono Yoshinori, Uchida Keisuke, Uchiyama Naomi, Hatada Hiroshi, Ogawa Souichiro, Iwakiri Hisayoshi, Kawakami Hiroshi

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan.

出版信息

World J Hepatol. 2024 Dec 27;16(12):1505-1514. doi: 10.4254/wjh.v16.i12.1505.

DOI:10.4254/wjh.v16.i12.1505
PMID:39744203
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11686534/
Abstract

BACKGROUND

The purpose of this case report is to describe a case of multiple intrahepatic artery aneurysms during treatment for IgG4-related sclerosing cholangitis (IgG4-SC) and to provide information for daily practice.

CASE SUMMARY

A 64-year-old Japanese woman was diagnosed with IgG4-SC five years prior and was receiving maintenance treatment with prednisolone 7.5-10 mg/day. She developed abdominal pain and a sudden onset of black stool and was admitted to our hospital. Abdominal contrast-enhanced computed tomography (CT) and ultrasonography (US) revealed multiple intrahepatic artery aneurysms that developed during the treatment for IgG4-SC. Emergency transarterial embolization for multiple hepatic artery aneurysms was performed. Hepatic artery aneurysms disappeared on contrast-enhanced CT and US, the progression of anemia ceased, and the melena resolved. Thus, hemostasis was achieved.

CONCLUSION

Hepatic artery aneurysms should be considered poor prognostic complications of IgG4-SC.

摘要

背景

本病例报告的目的是描述1例IgG4相关性硬化性胆管炎（IgG4-SC）治疗期间发生多发性肝内动脉瘤的病例，并为日常临床实践提供信息。

病例摘要

一名64岁日本女性5年前被诊断为IgG4-SC，目前正接受每日7.5-10mg泼尼松龙的维持治疗。她出现腹痛并突然排黑便，随后入住我院。腹部增强计算机断层扫描（CT）和超声检查（US）显示，在IgG4-SC治疗期间出现了多发性肝内动脉瘤。对多发性肝动脉瘤进行了急诊经动脉栓塞术。增强CT和US显示肝动脉瘤消失，贫血进展停止，黑便消失。从而实现了止血。

结论

肝动脉瘤应被视为IgG4-SC预后不良的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/71264a1d1471/WJH-16-1505-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/e01a405cf843/WJH-16-1505-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/91260c1dc288/WJH-16-1505-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/418c73588c70/WJH-16-1505-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/486d40080cd9/WJH-16-1505-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/71264a1d1471/WJH-16-1505-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/e01a405cf843/WJH-16-1505-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/91260c1dc288/WJH-16-1505-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/418c73588c70/WJH-16-1505-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/486d40080cd9/WJH-16-1505-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36fb/11686534/71264a1d1471/WJH-16-1505-g005.jpg

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Endovascular Management of Hepatic Artery Pseudoaneurysms: A Case Series.
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Management of a common and proper hepatic artery aneurysm.肝总动脉动脉瘤的管理
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Multiple Artery Aneurysms: Unusual Presentation of IgG4 Vasculopathy.多发性动脉瘤：IgG4 相关性血管病的罕见表现。
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The impact of long-term corticosteroid use on acute postoperative complications following lumbar decompression surgery.长期使用皮质类固醇对腰椎减压术后急性并发症的影响。
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