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[关节镜下半月板切除术后小儿腘动脉假性动脉瘤]

[Pseudoaneurysm of the pediatric popliteal artery after arthroscopic meniscus resection].

作者信息

Hofmann W, Forstner R, Forstner K

机构信息

Landesklinik für Gefässchirurgie, Landeskrankenanstalten Salzburg, Osterreich.

出版信息

Chirurg. 2000 Apr;71(4):469-71. doi: 10.1007/s001040051086.

Abstract

Arterial injuries following arthroscopic procedures are extremely rare, but may have dramatic consequences without early diagnosis and appropriate treatment. We report a case of popliteal artery pseudo-aneurysm a following arthroscopic meniscectomy in a child. Non-invasive diagnostic workup included Doppler flow color imaging and computed tomography with contrast and 3D workup. The arterial lesion was repaired surgically by an posterior approach using a vein patch plasty. The popliteal artery is in close relationship to the posterior capsule of the knee joint. During knee flexion the vessel is positioned forward and placed even closer to the horn of the lateral meniscus. For this reason arthroscopic surgical manipulation in the posterior aspects of the knee joint must be performed under direct visualization. Indistinct swelling in the popliteal fossa and calf following arthroscopic surgery should arouse suspicion of an arterial injury.

摘要

关节镜手术后的动脉损伤极为罕见,但如果不早期诊断和进行适当治疗,可能会产生严重后果。我们报告一例儿童关节镜下半月板切除术后腘动脉假性动脉瘤的病例。非侵入性诊断检查包括多普勒血流彩色成像以及增强计算机断层扫描和三维成像。通过后路采用静脉补片成形术对动脉病变进行了手术修复。腘动脉与膝关节后囊关系密切。在膝关节屈曲时,血管向前移位,甚至更靠近外侧半月板的角部。因此,膝关节后方的关节镜手术操作必须在直视下进行。关节镜手术后腘窝和小腿出现不明显肿胀应引起对动脉损伤的怀疑。

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