肝动脉动脉瘤破裂12例报告

RUPTURE OF HEPATIC ANEURYSMS:A REPORT OF 12 CASES

本文分析我院自1957年至1987年间收治的12例肝动脉动脉瘤破裂大出血,10例破入胆道,2例破入上消化道和腹腔。肝外动脉动脉瘤5例,肝内动脉动脉瘤7例。肝动脉动脉瘤破裂术前诊断甚难,唯选择性腹腔动脉和/或肠系膜上动脉造影最有诊断价值。手术治疗8例,其中5例死亡,死亡率主要取决于原发病和动脉瘤局部病变情况。

Data on acute rupture of hepatic artery aneurysms between March 1957 and November 1987 were analysed. There were 5 extrahepatic and 7 intrahepatic artery aneurysms. Ten aneurysms ruptured into the biliary tract and one each into jejunum and abdominal cavity. Ten aneurysms resulted from choledochitis or pancreatitis and 2 were due to iatrogenic trauma. To make a correct preoperative diagnosis is difficult. The most valuable examination is selective angiography of the celiac and superior mesenteric arteries. Four patients were correctly diagnosed by arteriography before operation. Eight patients were treated surgically and 5 died. Prognosis depended primarily on the condition of the aneurysms and the underlying disease.