Siablis D, Tepetes K, Vasiou K, Karnabatidis D, Perifanos S, Tzorakoleftherakis E
Department of Radiology, University Hospital of Patras.
Hepatogastroenterology. 1996 Sep-Oct;43(11):1343-6.
We present a case of hepatic artery injury with pseudoaneurysm formation following laparoscopic cholecystectomy. A 29-year-old man was referred to our hospital with right upper quadrant pain, jaundice and upper gastrointestinal bleeding one month after laparoscopic cholecystectomy. Gastroscopy showed mucosal erosions at the gastroesophageal junction. The patient did well after medical treatment only and was discharged one week later. However, ten days later he was readmitted with recurrent upper gastrointestinal bleeding. Usual laboratory tests, routine imagine diagnostic procedures and selective hepatic arteriogram were performed. Usual laboratory tests and routine imagine diagnostic procedures were inconclusive, but selective hepatic arteriogram showed a right hepatic artery pseudoaneurysm. The diagnosis of hemobilia was established. Embolization of the aneurysm with coils was carried out. Bleeding was controlled, the patient was discharged one week later and since then he remains under close follow up without any evidence of bleeding recurrence. We believe that the intraarterial embolization of a pseudoaneurysm is a safe and effective method to manage some complications such as bleeding or hemobilia.
我们报告一例腹腔镜胆囊切除术后发生肝动脉损伤并形成假性动脉瘤的病例。一名29岁男性在腹腔镜胆囊切除术后1个月因右上腹疼痛、黄疸和上消化道出血被转诊至我院。胃镜检查显示胃食管交界处黏膜糜烂。患者仅接受药物治疗后情况良好,1周后出院。然而,10天后他因再次出现上消化道出血而再次入院。进行了常规实验室检查、常规影像学诊断程序和选择性肝动脉造影。常规实验室检查和常规影像学诊断程序未得出明确结论,但选择性肝动脉造影显示右肝动脉假性动脉瘤。确诊为胆道出血。用弹簧圈对动脉瘤进行了栓塞。出血得到控制,患者1周后出院,此后一直密切随访,无出血复发迹象。我们认为,假性动脉瘤的动脉内栓塞是处理诸如出血或胆道出血等某些并发症的一种安全有效的方法。