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Transcatheter Embolotherapy: Posterior Pancreaticoduodenal Artery Aneurysm
經導管栓塞治療術：後胰臟十二指腸動脈瘤
摘要
一位四十歲男性在腹部不舒服之後幾天開始吐血及呈現休克狀態。腹部電腦斷層及血管攝影發現一個直徑一公分大小從後胰臟十二指腸動脈長出的動脈瘤。於是使用白金微線圈，和輔助的方法包括凝膠海綿立方體、組織黏膠和淋皮道卵造影液的混合物，以及動脈內升壓劑輸注經導管作栓塞治療。因為在血管攝影當中呈休克狀態，完全地加以栓塞是必須的。栓塞治療後的血管攝影發現只有微量的造影液從動脈瘤溢出。血紅素從栓塞前的5.1克／分生上升到治療後的8.3克／分生，隔天再上升到10.1克/分生。血壓從61/31毫米汞柱上升到127/62毫米汞柱。然而，這位病人幾天後因持續的代謝性酸中毒及多發性器官衰竭逝世。隨著經導管栓塞治療術的進步及微線圈及輔助工具適當的選擇，它可以提供最小的侵入性及最大的功效。
並列摘要
A 40 -year-old male presented with severe hematemesis and shock status after several days of abdominal discomfort. Abdominal computed tomography (CT) and angiography showed a 1-cmdiameter aneurysm from the posterior pancreaticoduodenal artery. Transcatheter embolotherapy with platinum microcoils and complementary methods including gelatin sponge cubes, surgical glue mixture and intra-arterial infusion of vasopressin were performed. Complete embolotherapy was mandatory because of the shock status during angiography. Angiography after the embolization therapy showed minimal extravasation of contrast medium from the aneurysm. Elevation of hemoglobin from 5.1 g/dl before embolotherapy to 8.3 g/dl after embolotherapy on the same day and 10.1 g/dl on the next day was noted. The blood pressure raised from 61/31 mmHg up to 127/62 mmHg. However, the patient expired after a few days due to persistent metabolic acidosis and multiple organ failure. With the technical improvement of transcatheter embolotherapy and proper selection of microcoils and complementary devices, it is a promising approach to provide minimal invasiveness and most effectiveness.
延伸閱讀
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