Imaeda Masaki, Onishi Yasuyuki, Yamasaki Yoshihiro, Ikeda Akihiro, Kawase Kango, Shirakami Taku, Taniguchi Takanori
Department of Radiology, Tenri Hospital, Japan.
Department of Cardiovascular Surgery, Tenri Hospital, Japan.
Interv Radiol (Higashimatsuyama). 2025 May 29;10:e20240048. doi: 10.22575/interventionalradiology.2024-0048. eCollection 2025.
A 75-year-old man with a history of open surgical repair for a thoracoabdominal aortic aneurysm presented with an aortic pseudoaneurysm at the anastomosis and a celiac artery aneurysm. During endovascular treatment, multiple celiac artery branches were embolized, and an aortic stent graft was placed to cover the aortic anastomosis and celiac artery origin. Four days post-treatment, a computed tomography scan revealed poor enhancement and fluid collection in the pancreatic body and tail, indicating acute ischemic pancreatitis with pancreatic necrosis. Computed tomography 22 days after treatment indicated enlargement of the fluid collection, leading to endoscopic ultrasound-guided drainage of the collection. Despite the low risk of ischemic complications, recognizing the risk of ischemic pancreatitis and splenic infarction when multiple celiac artery branches are embolized to treat celiac artery aneurysms is crucial.
一名75岁男性,有胸腹主动脉瘤开放手术修复史,现因吻合口处主动脉假性动脉瘤和腹腔干动脉瘤就诊。在血管内治疗过程中,多个腹腔干分支被栓塞,并放置了主动脉覆膜支架以覆盖主动脉吻合口和腹腔干起始部。治疗后4天,计算机断层扫描显示胰体和胰尾强化不佳且有液体积聚,提示急性缺血性胰腺炎伴胰腺坏死。治疗22天后的计算机断层扫描显示液体积聚增大,遂行内镜超声引导下积液引流。尽管缺血并发症风险较低,但在栓塞多个腹腔干分支以治疗腹腔干动脉瘤时,认识到缺血性胰腺炎和脾梗死的风险至关重要。