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破裂的上半导体动脉伪动脉瘤与出血性冲击继发性感染性结肠炎:一个病例报告
Maha Khan1, Emily Erdman2, Eric H Chou2,3
1Surgery, Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, USA.
Cureus
|March 13, 2026
概括
破裂的上层中枢动脉 (SMA) 伪动脉瘤是罕见的,但危及生命的. 这一案例表明,传染性结肠炎可以导致SMA伪动脉瘤破裂和二次缺血性结肠炎,强调早期诊断.
科学领域:
- 血管外科 血管外科
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
背景情况:
- 上层中枢动脉 (SMA) 伪动脉瘤是不常见的血管紧急情况,通常是创伤,感染或医疗程序造成的.
- 破裂可能导致严重出血,并损害了肠道的血液流动.
- 感染性结肠炎可能伴有腹痛和腹,但很少导致血管并发症.
研究的目的:
- 报告一个独特的SMA伪动脉瘤破裂的病例,这是传染性结肠炎的次要病例.
- 为了突出潜在的进展到缺血性结肠炎和肠道穿孔.
- 强调早期识别和多学科管理大肠炎患者血管并发症的重要性.
主要方法:
- 一个66岁的女性的病例报告,她有椎炎的病史.
- 最初呈现大肠炎的症状,其次是血动力学不稳定的复发.
- 通过CT血管造影进行诊断,发现破裂的SMA伪动脉瘤和活跃出血.
- 干预通过导管栓塞的干预.
- 随后对肠道缺血和穿孔的治疗.
主要成果:
- 患者在感染性结肠炎的背景下出现了破裂的SMA伪动脉瘤.
- 破裂导致腹腔内出血,需要紧急通过导管栓塞.
- 患者随后经历了肠道缺血和穿孔,需要进行广泛的手术干预.
- 需要长时间的重症监护室 (ICU) 住院和退院到长期急性护理.
结论:
- 这个案例说明了从传染性大肠炎到血管灾难和二次缺血性大肠炎的不寻常途径.
- 在低血压性结肠炎患者中,早期识别潜在的败血与出血性休克至关重要.
- 计算机图像扫描和协调护理对于管理如此复杂的病例至关重要.
- 临床医生必须在结肠炎患者出现出血或休克时保持对血管并发症的高度怀疑指数.
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