没有动脉瘤的腹腔大动脉破裂与巨细胞动脉炎相关:一个病例报告
Akito Kuwano1, Masaru Yoshikai1, Satoshi Ohtsubo1
1Department of Cardiovascular Surgery, Shin-Koga Hospital, Kurume, Fukuoka, Japan.
Annals of vascular diseases
|June 9, 2025
概括
巨细胞动脉炎可以在没有动脉瘤的情况下导致腹腔大动脉破裂. 这种罕见的疾病需要及时诊断和手术干预才能生存.
科学领域:
- 血管外科 血管外科
- 类风湿病学 类风湿病学
- 病理学 病理学 病理学
背景情况:
- 腹腔大动脉破裂是一种危及生命的疾病.
- 巨细胞动脉炎 (GCA) 是一种全身性血管炎,主要影响大动脉和中动脉.
- 大动脉参与GCA通常呈现为动脉瘤扩张.
研究的目的:
- 报告一个罕见的腹腔大动脉破裂没有动脉瘤与巨细胞动脉炎相关的病例.
- 强调在对大动脉紧急情况的差异诊断中考虑GCA的重要性.
主要方法:
- 一个67岁的妇女的病例报告,急性呈现.
- 诊断成像包括对比增强计算机断层扫描 (CECT).
- 切除的大动脉壁的紧急外科探索和组织病理学检查.
主要成果:
- 通过CECT检测出一个巨大的逆皮质血瘤,从腹腔大动脉有活跃的对比泄漏.
- 紧急手术确定了前大动脉壁上的破裂部位,没有动脉瘤的证据.
- 组织病理学证实巨细胞透 (CD68阳性),诊断巨细胞动脉炎.
结论:
- 巨细胞动脉炎可以表现为大动脉破裂,而不会先发生动脉瘤.
- 这一案例强调了GCA的非典型表现,以及在血管紧急情况中需要保持警.
- 在这种罕见的场景中,及时诊断和管理对于患者的结果至关重要.
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