成功通过腹腔镜动脉结扎脾肠管干脾动脉瘤:病例报告和文献综述。

IF 0.7 Q4 SURGERY
Shigeya Takeo, Hideki Izumi, Hisamichi Yoshii, Rika Fjino, Masaya Mukai, Hidekazu Furuya, Akiyoshi Yamamoto, Shunsuke Kamei, Yukihisa Ogawa, Terumitsu Hasebe, Junichi Kaneko, Hiroyasu Makuuchi
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引用次数: 0

摘要

背景:脾动脉瘤破裂的死亡率非常高,无论有无症状,动脉瘤大于 30 毫米的患者都建议接受治疗。我们在此报告了一例脾动脉瘤伴有异常分叉的病例,该病例通过腹腔镜结扎脾动脉得到了治疗:一名 51 岁的日本男性因体检时发现腹部超声心动图显示脾动脉瘤而被转诊至我院。脾动脉与肠系膜上动脉(SMA)分叉,在分叉处发现一个 38 毫米的脾动脉瘤,因此进行了手术。术中进行了血管造影,在脾动脉分叉前放置了一根球囊导管,并进行了腹腔镜脾动脉结扎术,为突然出血做好准备。结扎脾动脉后,再次进行了血管造影,以确认没有脾动脉瘤,并且通过外周侧支血管可以看到外周脾动脉。术后第四天,患者康复出院。术后一个月进行的对比增强计算机断层扫描证实脾动脉瘤消失,对比增强后的脾外周动脉清晰可见:这是首次报道在腹腔镜下对脾动脉瘤进行安全的动脉结扎手术,该手术在脾动脉分叉处放置了一根球囊导管,脾动脉瘤的异常脾动脉分叉来自SMA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful laparoscopic arterial ligation of splenic artery aneurysm with a splenomesenteric trunk: a case report and literature review.

Background: The mortality rate of splenic artery aneurysm rupture is very high, and patients with aneurysms larger than 30 mm are recommended for treatment, regardless of the presence or absence of symptoms. We herein report a case of splenic artery aneurysm with an abnormal bifurcation that was treated with laparoscopic ligation of the splenic artery.

Case presentation: A 51 year-old Japanese male was referred to our hospital because a splenic artery aneurysm was noted on abdominal echocardiography during a medical examination. The splenic artery bifurcated from the superior mesenteric artery (SMA), and a 38-mm splenic artery aneurysm was found just after the bifurcation; thus, surgery was performed. Intraoperative angiography was performed, a balloon catheter was placed before the splenic artery bifurcation, and laparoscopic splenic artery ligation was performed to prepare for sudden bleeding. After ligation of the splenic artery, angiography was performed again to confirm the absence of the splenic artery aneurysm and that the peripheral splenic artery was visible through the peripheral collateral vessels. The patient was discharged on the fourth postoperative day, with good progress. Contrast-enhanced computed tomography performed 1 month postoperatively confirmed the disappearance of the splenic artery aneurysm, and the contrast-enhanced peripheral splenic artery was visible.

Conclusion: This is the first report of a safe laparoscopic artery ligation procedure for a splenic artery aneurysm with an abnormal splenic artery bifurcation from the SMA, in which a balloon catheter was placed at the splenic artery bifurcation.

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