肝脏创伤损伤的跨动脉栓塞后的肝脏缺血
Meng-Lin Han1,2, Chia-Hsun Lu1,2
1Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan.
Diagnostics (Basel, Switzerland)
|November 27, 2024
概括
通过动脉栓塞 (TAE) 治疗肝损伤很少导致缺血. 这种病例显示肝静脉损伤,而不是TAE,导致6和7段缺血,突出显示了手术前肝静脉评估的必要性.
科学领域:
- 干预性放射学 干预性放射学
- 肝胆道手术 肝胆道手术
- 血管成像 血管成像
背景情况:
- 超动脉栓塞 (TAE) 是创伤性肝损伤的标准治疗方法.
- 肝脏超选择性TAE很少导致治疗区域的缺血.
- 准确的手术前评估对于管理肝损伤至关重要.
研究的目的:
- 报告一个罕见的肝脏缺血和的TAE后创伤性肝损伤的病例.
- 在TAE和肝血管系统的背景下,研究6和7段缺血的病因.
- 强调评估肝血管解剖在肝脏干预手术前规划的重要性.
主要方法:
- 审查初始CT扫描结果显示对比度扩散.
- 执行紧急的跨动脉栓塞 (TAE).
- 随后的CT扫描以评估栓塞后的并发症,并评估肝脏静脉和动脉解剖.
主要成果:
- 最初的CT显示出显著的对比度扩散,需要紧急TAE.
- 由于持续出血的担忧,进行了第二次TAE.
- 术后的CT扫描显示肝脏部分6和7的局部缺血和亡.
- 分析显示了常见的肝动脉变异,并建议对附属右下肝静脉 (IHVs) 的损伤是缺血的原因,与TAE无关.
结论:
- 在这种情况下,肝缺血和亡是由于附属右下肝静脉 (IHVs) 的损伤造成的,而不是栓塞程序本身.
- 肝静脉变异的存在需要对肝静脉以及动脉和门静脉进行仔细的手术前评估.
- 对于没有动脉扩张的肝损伤,可以考虑保守的治疗,这需要进一步的研究.
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