Merrell S W, Gloviczki P
Section of Vascular Surgery, Mayo Graduate School of Medicine, Rochester, MN 55905.
J Vasc Surg. 1992 Jan;15(1):221-5. doi: 10.1067/mva.1992.30864.
Spontaneous arterial dissection may occur in a dramatic fashion and is often fatal if treatment is not instituted promptly. Diagnosis may be particularly difficult when cases of arterial dissection appear in unusual locations. We report a rare case of atraumatic dissection of the splenic artery that occurred in a 66-year-old male patient, who was admitted with acute severe epigastric and substernal pain, which worsened on inspiration. On admission, his physical examination was unremarkable, and he was hemodynamically stable. After excluding cardiopulmonary catastrophes and aortic dissection as a cause, a left retroperitoneal mass was found on arteriography to be a contained rupture of a splenic artery dissection. The patient underwent urgent resection of the splenic artery with preservation of the spleen. Splenic artery dissection is a rare condition. Only 11 cases have been previously published in the literature, and all of these cases were diagnosed after death. Successful management depends on consideration of the diagnosis, especially when other more common disease processes have been excluded.
自发性动脉夹层可能以一种急剧的方式发生，如果不及时进行治疗，往往会致命。当动脉夹层病例出现在不寻常的部位时，诊断可能会特别困难。我们报告了一例罕见的脾动脉非创伤性夹层病例，该病例发生在一名66岁男性患者身上，他因急性严重上腹部和胸骨后疼痛入院，吸气时疼痛加剧。入院时，他的体格检查无异常，血流动力学稳定。在排除心肺急症和主动脉夹层作为病因后，血管造影发现左腹膜后肿块是脾动脉夹层的局限性破裂。患者接受了脾动脉紧急切除术，脾脏得以保留。脾动脉夹层是一种罕见的病症。此前文献中仅发表过11例病例，所有这些病例均在死后才得以诊断。成功的治疗取决于对该诊断的考虑，尤其是在排除了其他更常见的疾病过程之后。
