Hado H S H, Scarpello J H B, Barton T, Scarborough H, Elhadd T A
Department of Endocrinology, Dudley Hospitals NHS Trust, Dudley, West Midlands, UK.
Emerg Med J. 2005 Mar;22(3):229-30.
An unusual presentation of thoracic aortic dissection in a 73 year old man is described. He was admitted to hospital with severe left sided pleuritic chest pain. Examination on admission was normal apart from minor tenderness on palpation of the left lower chest wall. Chest x ray showed cardiomegaly with right lung shadowing, and ventilation/perfusion scan was negative. Spiral computed tomography done on the fourth day showed a false lumen on the ascending aorta. He underwent surgery but deteriorated postoperatively because of intrathoracic bleeding and developed cardiac tamponade from which resuscitation was not possible.
本文描述了一名73岁男性胸主动脉夹层的罕见病例。他因左侧胸膜炎性胸痛入院。入院检查除左下胸壁触诊时有轻微压痛外均正常。胸部X光显示心脏扩大伴右肺阴影，通气/灌注扫描为阴性。第四天进行的螺旋计算机断层扫描显示升主动脉有假腔。他接受了手术，但术后因胸腔内出血而病情恶化，并出现心脏压塞，最终无法复苏。
