만성 췌장염에 병발된 간경색과 췌장 가성동맥류: 1예 보고

국문 초록 (Abstract)

간의 혈류는 간동맥과 간문맥으로 공급되기 때문에 간경색은 비교적 드문 질환이고 특히 수술이나 시술 등의 합병증으로 인한 간경색이 아닌 만성 췌장염에 의한 간경색은 더 드물다. 본 저자들은 평소 술을 자주 마시는 만성 췌장염 병력이 있는 31세 여자 환자가 복부 통증을 주소로 내원하여 만성 췌장염에 병발된 간경색과 하췌십이지장동맥의 가성동맥류를 진단하였고 헤파린 투여 및 코일색전술을 통하여 치료에 성공했던 증례를 경험하여 보고한다.

다국어 초록 (Multilingual Abstract)

Liver infarction is rare because of dual blood supply of the liver with hepatic artery and portal vein. And its occurrence as a complication of chronic pancreatitis is rarer. We present a case of chronic pancreatitis complicated by liver infarction and inferior pancreaticoduodenal artery pseudoaneurysm. A 31-year-old female with alcoholism presented with severe acute epigastric pain. Serum amylase and lipase were 203 IU/L and 78 IU/L, respectively. Initial computed tomography (CT) scan showed peripancreatic infiltration, fluid collection, right portal vein thrombosis, and a large wedge-shaped low attenuation in the right hepatic lobe. The patient has been treated with heparin. Follow-up CT scan done after 4 days of heparin treatment demonstrated a pseudocyst with internal hemorrhage and a pseudoaneurysm. Angiography revealed a pseudoaneurysm in inferior pancreaticoduodenal artery. Coil embolization of the artery was done. The patient has been discharged without complication. Follow-up CT scan showed resolution of liver infarction, portal vein thrombosis and pseudoaneurysm.