Kibbler C C, Cohen D L, Cruicshank J K, Kushwaha S S, Morgan M Y, Dick R D
Gut. 1985 Jul;26(7):752-6. doi: 10.1136/gut.26.7.752.
Hepatic artery aneurysms occur infrequently and are often difficult to diagnose. Non-invasive procedures such as ultrasound or computer assisted tomography have not been considered suitable for definitive diagnosis and angiography is usually required. A patient is described in whom a mycotic hepatic artery aneurysm developed during the course of subacute bacterial endocarditis. The definitive diagnosis was made using computer assisted tomography with intravenous contrast enhancement and angiography was undertaken only as a prelude to transcatheter embolisation. The same technique was used to monitor progress after embolisation precluding the need for follow up angiography. As 80% of patients with hepatic artery aneurysm present for the first time after aneurysm rupture, the mortality associated with this condition is high. More widespread use of intravenous contrast enhanced tomography for abdominal examination in patients with unexplained abdominal pain might result in earlier diagnosis of this condition.
肝动脉瘤很少见，且常常难以诊断。诸如超声或计算机断层扫描等非侵入性检查方法一直被认为不适用于明确诊断，通常需要进行血管造影。本文描述了一名患者，其在亚急性细菌性心内膜炎病程中发生了霉菌性肝动脉瘤。通过静脉注射造影剂增强的计算机断层扫描做出了明确诊断，血管造影仅作为经导管栓塞术的前奏进行。栓塞术后采用相同技术监测病情进展，无需进行后续血管造影。由于80%的肝动脉瘤患者首次就诊是在动脉瘤破裂之后，因此该病的死亡率很高。对于不明原因腹痛的患者，更广泛地使用静脉注射造影剂增强的断层扫描进行腹部检查可能会使该病得到更早诊断。
