Chong K C, Yap E C, Lam K S, Low B Y
Department of Orthopaedic Surgery, Changi General Hospital, Singapore.
Ann Acad Med Singap. 2004 Mar;33(2):267-9.
We describe an alternative presentation of 2 cases of femur fractures with pseudoaneurysms of the profunda femoris artery.
In both cases, there is a recurrent triad of: (1) thigh swelling, (2) bleeding from the fasciotomy wound, and (3) anaemia with a falling haemoglobin trend.
Surgical exploration is often not diagnostic or therapeutic. Angiography can accurately diagnose the presence of a pseudoaneurysm and intervention with coil embolisation is effective in arresting further bleeding.
Both cases show good outcome following coil embolisation.
Recognition of this triad is necessary to ensure early accurate diagnosis so that proper treatment is rendered to prevent further recurrent bleeds.
我们描述了2例股骨干骨折合并股深动脉假性动脉瘤的另一种表现形式。
在这两例病例中，均反复出现以下三联征：（1）大腿肿胀，（2）筋膜切开伤口出血，（3）贫血且血红蛋白呈下降趋势。
手术探查往往无法起到诊断或治疗作用。血管造影可准确诊断假性动脉瘤的存在，采用弹簧圈栓塞进行干预能有效止血。
两例病例在弹簧圈栓塞术后均取得良好效果。
认识到这三联征对于确保早期准确诊断很有必要，以便进行恰当治疗，防止进一步反复出血。
