Hoffmann R, Marincek B, Roggo A, Jost R, Schneider J, Turina M
Departement Chirurgie, Universitätsspital Zürich.
Langenbecks Arch Chir. 1993;378(1):12-6. doi: 10.1007/BF00207988.
A male patient known to have hemophilia A was operated on twice (1990, 1991) in the Department of Surgery, University Hospital, Zurich, first because of severe intraabdominal hemorrhage from a liver artery aneurysm, and then because of a ruptured common hepatic artery aneurysm. The second surgical intervention revealed necrosis of the head and body of the pancreas. We consider that the pancreatic necrosis had resulted from the aneurysm, in view of the patient's history of silent pancreatitis and the uncomplicated postoperative course. Immediate reconstruction of the common hepatic artery aneurysm (in the presence of an occluded gastroduodenal artery) was performed with saphenous vein interposition. Because visceral aneurysms may be multiple, further aneurysms must be sought at the time of the first diagnosis. Elective surgery is the method of choice, because 40-80% of visceral aneurysms rupture spontaneously, with a high mortality rate. The mortality rate for elective surgery is now low.
一名已知患有甲型血友病的男性患者于1990年和1991年在苏黎世大学医院外科接受了两次手术，第一次是因为肝动脉动脉瘤导致严重的腹腔内出血，第二次是因为肝总动脉瘤破裂。第二次手术发现胰腺头部和体部坏死。鉴于患者有隐匿性胰腺炎病史且术后病程顺利，我们认为胰腺坏死是由动脉瘤引起的。在胃十二指肠动脉闭塞的情况下，立即用大隐静脉移植进行肝总动脉瘤重建。由于内脏动脉瘤可能是多发的，在首次诊断时必须寻找其他动脉瘤。选择性手术是首选方法，因为40%-80%的内脏动脉瘤会自发破裂，死亡率很高。目前选择性手术的死亡率较低。
