Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries.Spontaneously ruptured aneurysm of the hepatic artery is seldom described.We report ...Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries.Spontaneously ruptured aneurysm of the hepatic artery is seldom described.We report the case of an 89-year-old woman presenting with abdominal pain,jaundice and gastrointestinal bleeding,whose ultrasound and computed tomography revealed a non-traumatic,spontaneous aneurysm of the right hepatic artery.The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater,nor anywhere else.Selective angiography confirmed the diagnosis of hepatic artery aneurysm and revealed a full hepatic artery originating from the superior mesenteric artery.The patient was successfully treated by selective embolization of microcoils.We discuss the etiologies of hemobilia and its treatment with selective embolization,which remains favored over surgical treatment.Although aneurysm of the hepatic artery is rare,especially without trauma,a high index of suspicion is needed in order to ensure appropriate treatment.展开更多
目的:探讨3D打印技术在颅内动脉瘤介入栓塞术中的应用价值。方法:选取2015年12月-2016年11月滨州医学院附属医院介入手术室颅内动脉瘤介入栓塞患者60例,各30例。对照组应用传统栓塞方法治疗;试验组采用3D-DSA旋转成像,提取检查结果的DI...目的:探讨3D打印技术在颅内动脉瘤介入栓塞术中的应用价值。方法:选取2015年12月-2016年11月滨州医学院附属医院介入手术室颅内动脉瘤介入栓塞患者60例,各30例。对照组应用传统栓塞方法治疗;试验组采用3D-DSA旋转成像,提取检查结果的DICOM原始数据,输入Mimics16软件中进行动脉瘤复合体三维重建,在重建模型内设计出微导管塑形模型,将模型文件导入3D打印机(Nobel 1.0 3D Printer)按1∶1比例3D打印,获得实体模型,根据实体模型将微导管塑形进行栓塞。对比对照组与试验组手术结果。结果:3D打印模型试验组微导管均到位精准,栓塞顺利,术前谈话时间(13.140±2.024)min,手术时间(27.913±2.810)min。而对照组30例患者中1例微导管未到位,栓塞失败,2例栓塞时间超过1 h,术前谈话时间(18.200±3.101)min,手术时间(47.483±11.217)min。两组术前谈话时间及术中操作时间差异有统计学意义(P<0.01)。结论:3D打印模型应用于颅内动脉瘤介入栓塞中可以减少微导管操作并发症,缩短手术时间,提高手术成功率及患者满意率。展开更多
文摘Hemobilia is an uncommon and potential life-threatening condition mainly due to hepato-biliary tree traumatic or iatrogenic injuries.Spontaneously ruptured aneurysm of the hepatic artery is seldom described.We report the case of an 89-year-old woman presenting with abdominal pain,jaundice and gastrointestinal bleeding,whose ultrasound and computed tomography revealed a non-traumatic,spontaneous aneurysm of the right hepatic artery.The oeso-gastro-duodenoscopy and colonoscopy did not reveal any bleeding at the ampulla of Vater,nor anywhere else.Selective angiography confirmed the diagnosis of hepatic artery aneurysm and revealed a full hepatic artery originating from the superior mesenteric artery.The patient was successfully treated by selective embolization of microcoils.We discuss the etiologies of hemobilia and its treatment with selective embolization,which remains favored over surgical treatment.Although aneurysm of the hepatic artery is rare,especially without trauma,a high index of suspicion is needed in order to ensure appropriate treatment.
文摘目的:探讨3D打印技术在颅内动脉瘤介入栓塞术中的应用价值。方法:选取2015年12月-2016年11月滨州医学院附属医院介入手术室颅内动脉瘤介入栓塞患者60例,各30例。对照组应用传统栓塞方法治疗;试验组采用3D-DSA旋转成像,提取检查结果的DICOM原始数据,输入Mimics16软件中进行动脉瘤复合体三维重建,在重建模型内设计出微导管塑形模型,将模型文件导入3D打印机(Nobel 1.0 3D Printer)按1∶1比例3D打印,获得实体模型,根据实体模型将微导管塑形进行栓塞。对比对照组与试验组手术结果。结果:3D打印模型试验组微导管均到位精准,栓塞顺利,术前谈话时间(13.140±2.024)min,手术时间(27.913±2.810)min。而对照组30例患者中1例微导管未到位,栓塞失败,2例栓塞时间超过1 h,术前谈话时间(18.200±3.101)min,手术时间(47.483±11.217)min。两组术前谈话时间及术中操作时间差异有统计学意义(P<0.01)。结论:3D打印模型应用于颅内动脉瘤介入栓塞中可以减少微导管操作并发症,缩短手术时间,提高手术成功率及患者满意率。
