Delayed Intracystic Hemorrhage after Percutaneous Drainage and Sclerotherapy for a Symptomatic Giant Hepatic Cyst: A Case Report.

Koji Mikami, Hiroshi Yukimoto
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Abstract

Herein, we have reported a rare case of intracystic hemorrhage due to rupture of a right hepatic artery pseudoaneurysm in a 76-year-old female patient who underwent drainage and 3% polidocanol sclerotherapy for a symptomatic giant hepatic cyst. One month after sclerotherapy, the patient presented to the emergency room with acute and severe abdominal pain. Non-contrast T1-weighted magnetic resonance imaging findings showed high hepatic cyst fluid signal intensity and abdominal arteriography findings revealed a right hepatic artery pseudoaneurysm surrounding the hepatic cystic wall. Therefore, the patient was diagnosed with intracystic hemorrhage due to a ruptured pseudoaneurysm. Embolization, using a detachable coil, was successful. Interventional radiologists should be aware of potential vascular injuries during drainage and sclerotherapy for giant hepatic cysts.

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有症状的巨大肝囊肿经皮引流及硬化治疗后迟发性囊内出血1例报告。
在此,我们报告一例罕见的右肝动脉假性动脉瘤破裂导致囊内出血的病例,该病例为76岁的女性患者,因有症状的巨大肝囊肿,接受引流和3%聚多醇硬化治疗。硬化治疗一个月后,患者以急性和严重腹痛就诊于急诊室。非对比t1加权磁共振成像显示肝囊肿液信号强度高,腹部动脉造影显示肝囊壁周围有右肝动脉假性动脉瘤。因此,患者被诊断为假性动脉瘤破裂引起的囊内出血。使用可拆卸线圈的栓塞术很成功。介入放射科医师在对巨大肝囊肿进行引流和硬化治疗时应注意潜在的血管损伤。
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