复杂的腹部创伤性假性动脉瘤和动静脉瘘形态学分析

Morphologic analysis of abdominal traumatic pseudoaneurysm and arteriovenous fistula

目的分析腹部创伤性假性动脉瘤和动静脉瘘形态学特点。方法分析1例复杂的腹部创伤性假性动脉瘤和动静脉瘘临床资料,总结腹部创伤性假性动脉瘤和动静脉瘘形态学特点。结果患者在腹部刀刺伤术后,出现顽固性腹水、低蛋白血症、门静脉高压症;彩色多普勒、螺旋CT和数字减影血管造影(DSA)提示肝总动脉、腹主动脉瘤形成,肝动脉门静脉瘘和腹主动脉门静脉瘘。采用血管内介入方法,行腹主动脉和门静脉支架植入术,动脉瘤和动脉门静脉瘘栓塞术,门静脉高压症消失,患者康复出院。结论腹部创伤性假性动脉瘤和动静脉瘘解剖结构复杂,具有独特的形态学特点;给诊断治疗带来困难。

Objective To analyze the morphologic features of abdominal traumatic pseudoaneurysm and arteriovenous fistula.Methods The clinical data of one cases of abdominal traumatic pseudoaneurysm and arteriovenous fistula was analyzed retrospectively and the morphologic features was summarized.Results The patient had refractoriness ascites,hypoproteinemia and portal hypertension after operation.Colour doppler ultrasound,spiral computed tomography and digital subtraction angiography（DSA） showed an aneurysm in abdominal aorta and common hepatic artery respectively and the arteriovenous fistula lay between portal vein and common hepatic artery and abdominal aorta.The patient underwent stent implantation in abdominal aorta and portal vein and pseudoaneurysm and arteriovenous fistula embolization.Portal hypertension got eradication and the patient was discharged.Conclusion Abdominal traumatic visceral arteriovenous fistula had special morphologic character and complex anatomic structure.It is difficute in diagnosis and treatment of abdominal traumatic pseudoaneurysm and arteriovenous fistula.