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腹主动脉瘤急性闭塞并发双下肢静脉血栓形成:一例报告

Acute occlusion of an abdominal aortic aneurysm complicated by bilateral lower extremity venous thrombosis: A case report.

作者信息

Bridges Kenneth G., Donnelly Joseph C.

机构信息

Department of Surgery, Lankenau Hospital, Philadelphia, Pennsylvania (affiliated with the Thomas Jefferson Medical School, Philadelphia, Pennsylvania).

出版信息

Cardiovasc Dis. 1981 Mar;8(1):93-101.

Abstract

Acute occlusion of an abdominal aortic aneurysm is a rare phenomenon. Its possible complications include distal spasm followed by arterial thrombosis, ischemia of the distal limbs, distal embolization, acidosis, hyperkalemia, and the development of venous thrombosis of the lower limbs. Surgical correction is often complicated by cardiac decompensation, renal failure, fatal pulmonary embolism, and metabolic derangements related to toxins released from the revascularized limb. Unless contraindicated, immediate systemic heparinization must be undertaken when the diagnosis is first suspected. We present a case of sudden occlusion of an abdominal aortic aneurysm complicated by venous thrombosis involving both lower extremities. After undergoing surgical revascularization, the patient sustained massive fatal pulmonary emboli. Prophylactic interruption of the inferior vena cava may be indicated in patients who present with this complication of abdominal aortic aneurysm.

摘要

腹主动脉瘤急性闭塞是一种罕见现象。其可能的并发症包括远端痉挛继而动脉血栓形成、远端肢体缺血、远端栓塞、酸中毒、高钾血症以及下肢静脉血栓形成。手术矫正常因心脏代偿失调、肾衰竭、致命性肺栓塞以及与再血管化肢体释放的毒素相关的代谢紊乱而复杂化。除非有禁忌证,一旦首次怀疑诊断,必须立即进行全身肝素化。我们报告一例腹主动脉瘤突然闭塞并伴有双下肢静脉血栓形成的病例。在接受手术再血管化后,患者发生了大量致命性肺栓塞。对于出现腹主动脉瘤这种并发症的患者,可能需要预防性阻断下腔静脉。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4917/287905/2eae21136b3d/cardiodis00001-0095-a.jpg

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