Lam E Y, McLafferty R B, Taylor L M, Moneta G L, Edwards J M, Barton R E, Petersen B, Porter J M
Department of Surgery, Dotter Interventional Institute, Oregon Health Sciences University, Portland, USA.
J Vasc Surg. 1998 Sep;28(3):566-9. doi: 10.1016/s0741-5214(98)70147-8.
Two patients had inferior epigastric artery pseudoaneurysms after therapeutic paracentesis for ascites caused by portal hypertension. The first patient, a 62-year-old man, had a two-week history of left lower quadrant pain, tenderness, and nonpulsatile mass after a paracentesis for ascites. A left inferior epigastric artery pseudoaneurysm measuring 10 cm in diameter and 20 cm in length was diagnosed by means of Duplex ultrasound and arteriography. The patient was treated with percutaneous embolization, with successful thrombosis of the pseudoaneurysm. The second patient, a 33-year-old woman, had a six-week history of left lower quadrant pain, tenderness, and nonpulsatile mass after a paracentesis for ascites. Computerized tomography and arteriography showed a left inferior epigastric artery pseudoaneurysm, measuring 7 cm in diameter and 9 cm in length. The patient was treated with percutaneous embolization with successful thrombosis of the pseudoaneurysm. Both patients were discharged in good condition 2 days after embolization. Inferior epigastric artery pseudoaneurysm is a complication of paracentesis, and percutaneous embolization may be preferable to surgical repair in patients with chronic liver failure and portal hypertension.
两名患者在因门静脉高压引起的腹水进行治疗性腹腔穿刺术后发生了腹壁下动脉假性动脉瘤。第一名患者是一名62岁男性，在进行腹水腹腔穿刺术后，左下象限疼痛、压痛并出现非搏动性肿块已有两周时间。通过双功超声和动脉造影诊断出一个直径10厘米、长度20厘米的左腹壁下动脉假性动脉瘤。该患者接受了经皮栓塞治疗，假性动脉瘤成功血栓形成。第二名患者是一名33岁女性，在进行腹水腹腔穿刺术后，左下象限疼痛、压痛并出现非搏动性肿块已有六周时间。计算机断层扫描和动脉造影显示一个直径7厘米、长度9厘米的左腹壁下动脉假性动脉瘤。该患者接受了经皮栓塞治疗，假性动脉瘤成功血栓形成。两名患者在栓塞后2天均状况良好出院。腹壁下动脉假性动脉瘤是腹腔穿刺的一种并发症，对于慢性肝功能衰竭和门静脉高压患者，经皮栓塞可能比手术修复更可取。
