Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases.
Arterial complications of pancreatitis: diagnostic and therapeutic aspects in 104 cases.
复制标题
DOI：
10.1016/s1051-0443(93)71920-x
复制
发表时间：
1993-07-01
期刊：
影响因子：
--
通讯作者：
Bigot, J M
中科院分区：
文献类型：
--
作者：
Boudghene, F;L'Hermine, C;Bigot, J M
目的：对104例与胰腺炎相关的动脉病变进行回顾性研究，比较动脉造影与超声（US）和计算机断层扫描（CT）的诊断和治疗价值。患者和方法：通过问卷调查获得数据。男性87例，女性17例（年龄21 ~ 80岁，平均48岁）。这些病变通常表现为出血（70例）、疼痛（69例）或两者兼而有之（46例）。结果：93例患者中有90例动脉造影立即呈阳性，但US和CT也可能偶然发现无症状病变（17例）。这些病变通常是单一的（90%），与假性囊肿（60%）或假性动脉瘤（48%）的动脉破裂有关。它们累及脾（42%）、胃十二指肠（22%）和胰腺小动脉（25%）。在32例进行栓塞治疗的病例中，所有病例均立即成功，但12例（37%）出血复发。25例患者的治疗取得了明确的成功（78%），5例患者死于出血（16%）。结论：动脉造影对于动脉病变的诊断仍然是必不可少的，栓塞可能是一种稳定的术前操作，也可用于立即止血。
PURPOSE: A retrospective study of 104 cases of arterial lesions related to pancreatitis was undertaken to examine the diagnostic and therapeutic benefits of arteriography compared with ultrasonography (US) and computed tomography (CT).PATIENTS AND METHODS: Data were acquired from responses to a questionnaire. Eighty-seven patients were men, 17 were women (age range, 21-80 years; mean, 48 years). These lesions were usually revealed by hemorrhage (70 cases), pain (69 cases), or both (46 cases).RESULTS: Arteriography was immediately positive in 90 of 93 patients in whom it was performed, but US and CT may also permit incidental discovery of silent lesions (17 cases). These lesions are often single (90%) and related to an arterial rupture in a pseudocyst (60%) or a pseudoaneurysm (48%). They involved the splenic (42%), the gastroduodenal (22%), and the small pancreatic arteries (25%). Of 32 cases in which embolization was performed, immediate success was achieved in all cases but bleeding recurred in 12 cases (37%). Treatment in 25 patients was a definitive success (78%), and five patients died of hemorrhage (16%).CONCLUSION: Arteriography remains essential for diagnosis of arterial lesions, and embolization may be indicated as a stabilizing preoperative procedure and also for immediately stopping hemorrhage.