Boudghène F, L'Herminé C, Bigot J M
Vascular and Interventional Unit, Hopital Tenon, Paris, France.
J Vasc Interv Radiol. 1993 Jul-Aug;4(4):551-8. doi: 10.1016/s1051-0443(93)71920-x.
A retrospective study of 104 cases of arterial lesions related to pancreatitis was undertaken to examine the diagnostic and therapeutic benefits of arteriography compared with ultrasonography (US) and computed tomography (CT).
Data were acquired from responses to a questionnaire. Eighty-seven patients were men, 17 were women (age range, 21-80 years; mean, 48 years). These lesions were usually revealed by hemorrhage (70 cases), pain (69 cases), or both (46 cases).
Arteriography was immediately positive in 90 of 93 patients in whom it was performed, but US and CT may also permit incidental discovery of silent lesions (17 cases). These lesions are often single (90%) and related to an arterial rupture in a pseudocyst (60%) or a pseudoaneurysm (48%). They involved the splenic (42%), the gastroduodenal (22%), and the small pancreatic arteries (25%). Of 32 cases in which embolization was performed, immediate success was achieved in all cases but bleeding recurred in 12 cases (37%). Treatment in 25 patients was a definitive success (78%), and five patients died of hemorrhage (16%).
Arteriography remains essential for diagnosis of arterial lesions, and embolization may be indicated as a stabilizing preoperative procedure and also for immediately stopping hemorrhage.
对104例与胰腺炎相关的动脉病变进行回顾性研究，以探讨血管造影术与超声检查（US）和计算机断层扫描（CT）相比在诊断和治疗方面的优势。
数据通过问卷调查获得。87例为男性，17例为女性（年龄范围21 - 80岁；平均48岁）。这些病变通常表现为出血（70例）、疼痛（69例）或两者皆有（46例）。
在接受血管造影术的93例患者中，90例结果立即呈阳性，但US和CT也可能偶然发现无症状病变（17例）。这些病变通常为单发（90%），与假性囊肿（60%）或假性动脉瘤（48%）内的动脉破裂有关。病变累及脾动脉（42%）、胃十二指肠动脉（22%）和胰腺小动脉（25%）。在32例行栓塞治疗的病例中，所有病例均立即成功，但12例（37%）出现出血复发。25例患者治疗取得最终成功（78%），5例患者死于出血（16%）。
血管造影术对于动脉病变的诊断仍然至关重要，栓塞可作为术前稳定病情的措施，也可用于立即止血。
