Walker P J, White G H, Harris J P, Alle K M, May J
Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Eur J Vasc Surg. 1992 Jul;6(4):434-7. doi: 10.1016/s0950-821x(05)80295-6.
Mycotic false aneurysms due to local arterial injury from attempted intravenous injections in drug addicts are increasing in frequency. The high incidence of HIV and hepatitis B virus in parenteral drug users may present a considerable risk to the treating personnel. This paper reports the unsuspected presence of broken needle-tips in the subcutaneous tissues of an intravenous drug abuser, in association with bilateral mycotic aneurysms of the axillary arteries. Broken needle-tips have the potential to cause needlestick injury to the operating team and the nursing staff, with the associated risk of transmission of HIV and hepatitis B virus infection. The presence of broken needle-tips should be suspected in drug users presenting with false aneurysms associated with local arterial injection injury and a specific history of needle-breakage should be sought. Preoperative plain radiographs should be performed of the planned operative field to exclude the presence of such needle-tips. Any soft tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being a false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management.
因吸毒者试图静脉注射导致局部动脉损伤而引起的霉菌性假性动脉瘤的发生率正在上升。静脉注射吸毒者中艾滋病毒和乙型肝炎病毒的高发病率可能给治疗人员带来相当大的风险。本文报告了一名静脉吸毒者皮下组织中意外出现的断针尖，同时伴有双侧腋动脉霉菌性动脉瘤。断针尖有可能对手术团队和护理人员造成针刺伤，并伴有艾滋病毒和乙型肝炎病毒感染传播的相关风险。对于出现与局部动脉注射损伤相关的假性动脉瘤的吸毒者，应怀疑有断针尖存在，并应询问是否有特定的断针病史。应对计划手术区域进行术前平片检查，以排除此类针尖的存在。静脉吸毒者主要动脉附近的任何软组织肿胀，在未得到其他证实之前，应怀疑为假性动脉瘤，并应立即转诊给血管外科医生进行检查和处理。
