肝动脉伪动脉瘤 - 梅奥诊所的经验和文献综述
Tatjana Gavrancic1, Muhammad Waqas Tahir1, Marko Gorasevic2
1Department of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL, United States.
Frontiers in medicine
|December 25, 2024
概括
肝动脉伪动脉瘤 (HAP) 是一种罕见的疾病,通常与手术或创伤有关. 虽然破裂和出血不会增加死亡率,但输血,瘤入侵,PVT和亡与更糟糕的结果有关.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 血管外科 血管外科
- 干预性放射学 干预性放射学
背景情况:
- 肝动脉伪动脉瘤 (HAP) 是一种罕见的,可能致命的血管并发症.
- 高血压通常在肝胆道手术,创伤或肝移植后出现.
- 自发的HAP发生不太常见,但有记录.
研究的目的:
- 审查HAP的病因学,临床表现,管理和结果.
- 确定与HAP患者死亡率增加相关的因素.
- 为了分析24年来在梅奥诊所接受治疗的大量队列的数据.
主要方法:
- 对27名被诊断患有HAP的患者进行了回顾性图表审查.
- 对人口统计,症状,HAP位置,病因和肝脏病理学的分析.
- 评估干预类型和患者结果,包括死亡率.
主要成果:
- HAP主要影响男性 (63%),中位数年龄57岁,主要是肝内 (85.2%) 在RHA (70.4%).
- 肝胆道手术或创伤导致89.9%的HAP病例;18%是偶然发现.
- 死亡率与输血需求 (p=0.021),瘤入侵 (p=0.023),PVT (p=0.02) 和肝硬化 (p=0.02) 有显著关联.
结论:
- 高血压是一种严重的疾病,需要谨慎管理,死亡率很高 (18.5%).
- 虽然破裂和胃肠道出血很常见,但它们不能独立预测死亡率.
- 早期识别输血需求,瘤入侵,PVT和肝硬化对于改善HAP患者的生存至关重要.
相关概念视频
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...