腹腔大动脉自发破裂伪动脉瘤:一个病例报告
Dono Antono1, David Hutagaol, Nindya Pbs Utami
1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.. dantonos@yahoo.com.
Acta medica Indonesiana
|July 16, 2024
概括
破裂的巨型腹腔大动脉伪动脉瘤可以在没有事先干预的情况下发生. 用接吻移植进行内血管动脉瘤修复 (EVAR) 为这种罕见的疾病提供了成功的治疗方法.
科学领域:
- 血管外科 血管外科
- 干预性放射学 干预性放射学
- 大动脉动脉瘤研究研究
背景情况:
- 伪动脉瘤或虚假动脉瘤通常是由动脉损伤引起的,通常是由于穿孔部位不充分关闭而导致的导管相关干预后发生的.
- 虽然通常与干预有关,但罕见的伪动脉瘤病例在没有血管手术史的情况下发生.
- 巨型腹腔大动脉伪动脉瘤由于其大小和破裂潜力而构成重大临床挑战.
研究的目的:
- 报告一个独特的破裂巨型腹腔大动脉伪动脉瘤病例,该病例发生在没有先前血管干预史的患者身上.
- 为了说明内血管动脉瘤修复 (EVAR) 的成功应用,使用接吻移植技术来管理这种复杂的表现.
- 突出了腹腔大动脉自发性伪动脉瘤的诊断和治疗方面的考虑.
主要方法:
- 采用案例研究方法,详细介绍了患有破裂巨腹动脉伪动脉瘤的患者的临床表现,诊断工作和治疗.
- 患者出现了严重的腹痛,促使紧急成像检查以确定出血的来源.
- 内血管动脉瘤修复 (EVAR) 使用接吻移植配置进行,以排除伪动脉瘤并恢复大动脉血流.
主要成果:
- 患者,尽管没有血管干预史,但被诊断为破裂的巨型腹腔大动脉伪动脉瘤.
- 使用接吻移植的EVAR手术在技术上是成功的,完全排除了伪动脉瘤.
- 在干预后,患者经历了有利的结果,症状消失,大动脉病理的成功管理.
结论:
- 破裂的巨型腹腔大动脉伪动脉瘤可以自发发生,强调需要进行彻底的调查,即使没有催化剂的危险因素.
- 用接吻移植的Evar是一种可行的和有效的治疗选择,用于管理腹腔大动脉复杂的伪动脉瘤.
- 这一案例强调了考虑大动脉紧急情况的不常见病因以及内血管技术的多功能性的重要性.
相关概念视频
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...