Stierli P, Huber G F, Marty R, Eugster T, Gürke L
Universitäres Zentrum für Gefässchirurgie Aarau/Basel Kantonsspital, Aarau, Schweiz.
Chirurg. 2001 Aug;72(8):940-4. doi: 10.1007/s001040170093.
Pelvic and inguinal pain are a rare manifestation of arterial disease.
Description of four patients with acute or chronic pelvic or inguinal pain due to symptomatic dissection of the infrarenal aorta and/or iliac arteries.
In two cases the dissection was limited to the left iliac artery with an entry at the beginning of the common iliac artery. The re-entry was located in the distal external iliac or common femoral artery. In one patient additionally a infrarenal abdominal aortic aneurysm was found. In the other two patients the entry of the spontaneous dissection was in the position of the infrarenal aorta, with extension in one iliac artery. In two patients the diagnosis of Erdheim-Gsell media necrosis was histologically confirmed.
Spontaneous arterial dissection should be considered in patients with pelvic or inguinal pain. Absence of thoracic symptoms is possible if the entry of the dissection is distal, within the infrarenal aorta or iliac arteries. Prompt diagnosis with duplex sonography, CT, arteriography or MRA is indicated. The type of reconstruction depends on the extent of the dissection and the concomitant arterial disease.
盆腔和腹股沟疼痛是动脉疾病的罕见表现。
描述4例因肾下腹主动脉和/或髂动脉症状性夹层而出现急性或慢性盆腔或腹股沟疼痛的患者。
2例夹层仅限于左髂动脉，入口位于髂总动脉起始处。再入口位于髂外动脉远端或股总动脉。1例患者还发现了肾下腹主动脉瘤。另外2例患者自发性夹层的入口位于肾下腹主动脉位置，延伸至一条髂动脉。2例患者经组织学证实为埃尔代姆-格塞尔中层坏死。
盆腔或腹股沟疼痛患者应考虑自发性动脉夹层。如果夹层入口在远端，即在肾下腹主动脉或髂动脉内，则可能没有胸部症状。建议通过双功超声、CT、动脉造影或磁共振血管造影进行快速诊断。重建类型取决于夹层的范围和伴随的动脉疾病。
