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The Aftermath of a Hepatic Artery Aneurysm—A Rare Etiology of Biliary Obstruction!

机译:肝动脉瘤的后果-胆道梗阻的罕见病因!

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Background:Hepatic artery aneurysms (HAAs) constitute 14% to 20% of visceral artery aneurysms. Most HAAs are asymptomatic. Although rare, obstructive jaundice due to external bile duct compression or rupture of the HAA into the biliary tree with occlusion of the lumen from blood clots has been reported.Case presentation:A 56-year-old white man presented to an outside hospital with symptoms of obstructive jaundice, including abdominal pain and yellowing of the skin. Imaging showed a large HAA. Patient was transferred to our hospital where an endoscopic retrograde cholangiopancreatography with biliary stenting was performed. This was followed by coil embolization of the HAA with improvement in symptoms and liver chemistries.Conclusions:Most clinicians agree that management of HAA is highly variable and depends on clinical presentation and anatomic location. Biliary stenting provides temporary relief for patients with obstructive jaundice. Definitive options include open aneurysmal repair versus endovascular therapy. Hepatic artery aneurysms represent a significant risk for hemorrhage and therefore must be addressed promptly once discovered.
机译:背景:肝动脉瘤(HAA)占内脏动脉瘤的14%至20%。大多数HAA无症状。尽管很少见,但据报道由于外部胆管受压或HAA破裂进入胆管树并伴有血栓管腔阻塞而导致梗阻性黄疸。病例报告:一名56岁的白人因症状出现在一家医院就诊阻塞性黄疸,包括腹痛和皮肤发黄。影像学检查显示HAA较大。病人被转移到我们的医院,在那里进行了胆道内镜逆行胰胆管造影术。结论:大多数临床医生都认为,HAA的治疗是高度可变的,并取决于临床表现和解剖位置。胆道支架置入术可为梗阻性黄疸患者提供暂时的缓解。最终选择包括开放性动脉瘤修复与血管内治疗。肝动脉瘤代表着重大的出血风险,因此一旦发现,必须立即解决。

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