Multidetector-row CTにより2個の遅発性仮性動脈瘤の自然消失を描出し得た鈍的肝損傷の1例

Abstract

A case of blunt hepatic injury with spontaneous resolution of two delayed hepatic pseudoaneurysms depicted on multidetector-row CT Atsuhiko Onaka, Keisuke Takano, Hiroyasu Oka, Toru Ueyama Masanori Matsusaka, Tatsuya Nakamura Emergency and Critical Care Center, Nara Prefectural Nara Hospital There have been few reports on spontaneous resolution of pseudoaneurysms after blunt hepatic injury. We report a case of blunt hepatic injury with spontaneous resolution of two delayed pseudoaneurysms depicted on multidetectorrow CT (MDCT). The patient was a 17-year-old male with hepatic injury after a motorcycle accident. Initial MDCT showed a complex deep hepatic injury, and there was no extravasation and no pseudoaneurysm on angiography. On a following MDCT, delayed formation of a 6-mm pseudoaneurysm on the 12th day after injury and a spontaneous resolution on the 19th day after injury were seen. Moreover, another 4-mm pseudoaneurysm was depicted on the 19th day after injury and disappeared on the 26th day after injury on MDCT. In this patient, pseudoaneurysms observed on arterial phase MDCT images were not be visualized in the portal venous phase, and arterial phase MDCT images were useful to demonstrate spontaneous resolution of delayed pseudoaneurysms. Arterial phase MDCT images could improve the detection of pseudoaneurysms. To evaluate pseudoaneurysms after blunt hepatic injury properly, arterial phase MDCT images are essential. (JJAAM. 2013; 24: 231-6)