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作为丸扭曲伪装的急性大动脉剖析:一个案例报告
Bruce M Lo1, Megyn K Christensen2, Coral E Byrns2
1Sentara Norfolk General Hospital/Eastern Virginia Medical School at Old Dominion University, Department of Emergency Medicine, Norfolk, Virginia.
Clinical practice and cases in emergency medicine
|February 10, 2026
概括
急性大动脉解剖 (AAD) 可以呈现异常,模仿丸扭曲等情况. 及时诊断对于这种危及生命的疾病至关重要,即使有不寻常的初始症状.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
- 紧急医疗 紧急医疗
背景情况:
- 大动脉解剖是一个危急的病情,如果诊断延迟,死亡率很高.
- 经典症状包括突然的胸部或背部疼痛,但非典型的表现可能会误导临床医生.
- 大动脉解剖的延迟诊断在紧急情况下是一个重大问题.
研究的目的:
- 报告一种罕见的急性大动脉解剖病例,最初呈现为丸疼痛.
- 强调在异常症状的患者中考虑主动脉剖析的重要性.
- 突出主动脉解剖的不常见表现所带来的诊断挑战.
主要方法:
- 一份病例报告,详细介绍患者通过诊断和治疗的旅程.
- 首次出现在急诊室,症状暗示丸扭曲.
- 随后返回急诊室,疼痛恶化,导致先进的成像和诊断主动脉解剖.
主要成果:
- 患者最初出现左丸疼痛,并评估丸扭曲.
- 扭曲的外科检查结果是负面的;患者被送出院.
- 病人带着背部疼痛回来,CT扫描显示了急性A型大动脉解剖.
- 患者接受了手术修复,并住院了12天.
结论:
- 急性大动脉解剖可以表现为模仿其他疾病的症状,例如丸扭曲.
- 当初诊断不能完全解释患者的症状时,临床医生应保持对大动脉解剖的高度怀疑指数.
- 这一案例强调了急诊医学需要广泛的差异诊断,特别是对于可能致命的疾病.
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