脾动脉瘤的诊断与治疗(附一例报告及文献复习)

Diagnosis and treatment of splenic aneurysm:a report of one case and review of literature

目的了解脾动脉瘤(splenic artery aneurysms,SAA)的临床特点、影像学表现及鉴别诊断,探讨SAA的诊断和治疗经验。方法回顾性分析2015年4月收治的1例因上腹部腹痛不适1周而入院的脾动脉瘤病人,行腹部CT平扫+增强提示脾动脉破裂并周围包裹,后行介入治疗,并结合其临床资料进行文献复习。结果随访病人1个月内未出现动脉瘤复发及上消化道出血等严重并发症,现已恢复正常生活。结论脾动脉瘤是一种起病隐匿且发病率较低的血管疾病,多数无特异性表现,CT平扫+增强对诊断脾动脉瘤具有重要意义,而CT血管造影能可靠、无创、立体地显示脾动脉瘤以及与载瘤动脉等的相互关系,能显著提高脾动脉瘤的诊断。目前手术(包括介入手术)是治疗脾动脉瘤行之有效的方法,对于有症状的脾动脉瘤应及时进行手术治疗。

Objective To summarize the clinical characteristics of splenic artery aneurysms （SAA）,imaging findings and differential diagnosis,and to discuss the diagnosis and treatment of SAA.Methods One case of SAA complained of pain in upper abdomen for about one week admitted in April,2015 was retrospectively analyzed.CT scan＋enhanced prompted the splenic artery rupture and surrounding wrapping.The patient was given interventional therapy,and the literature review in com-bination with clinical data was done.Results This patient did not show any complication such upper gastrointestinal bleeding or recurrence of the SAA,and the patient has been in normal life.Conclusions The splenic aneurysm is a hidden and lower incidence of vascular disease.It has no specific perform-ance.The CT scan＋enhancement have an important meaning for the diagnosis of SAA.CT angiogra-phy can be a reliable,noninvasive,three-dimensional way for revealing the correlation of splenic aneu-rysm and its parent artery,and it can significantly improve the diagnosis of SAA.The effective treat-ment for SAA is surgical operation （including interventional treatment）.The symptomatic SAA should be treated timely.