Aneurysms of the splanchnic vessels are uncommon but eventually life threatening lesions. 1, 2 The majority of these aneurysms are asymptomatic but they may progress and cause nonspecific symptoms such as abdominal discomfort and pain.' Occasionally a vascular bruit may be heard over the aneurysm. Spontaneous rupture is an uncommon but disastrous complication associated with a high mortality rate.3 In recent years ultrasound has provided a new non-invasive method to detect such lesions.This case report describes a woman with an aneurysm of the common hepatic artery diagnosed by real-time sonography.
CASE REPORTA 45-year-old woman with a previous history of upper abdominal trauma, cerebral emboli, and severe menorrhagia but otherwise normal was examined because of recurrent attacks of upper abdominal discomfort and right flank pain for 4 months. Blood pressure, pulse rate, and routine laboratory tests were normal with the exception of slightly elevated hepatic enzymes. Roentgenological examination of the upper GI tract was normal. A real-time sonography of the liver and the pancreas revealed an echofree mass in the region of the head of the pancreas, and a cyst or cystic tumor in the head of the pancreas was suspected. A percutaneous biopsy was considered but since the sonographer was uncertain of the diagnosis, the patient was referred to our hospital for a new examination. This was performed with a Technicare Auto Sector real-time scanner (TechFrom the
Ultrasound examination was performed in 53 jaundiced patients; successful examination was accomplished in 48. Ultrasonography revealed mechanical biliary obstruction in 34 of 35 patients with obstructive jaundice. Dilatation of the intrahepatic or extrahepatic biliary ducts or the gallbladder was not present in any patient with non-obstructive jaundice. The value of ultrasound examination in the differential diagnosis of jaundice is emphasized.
Ultrasound examination and hypotonic duodenography were performed in 25 patients with obstructive jaundice. The diagnostic value of both methods with special reference to tumors in the head of the pancreas is discussed.
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