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主动脉结核性假性动脉瘤:一种与脊柱结核罕见的关联。

Tubercular pseudoaneurysm of aorta: a rare association with vertebral tuberculosis.

作者信息

Jain Anil K, Chauhan Ravindra S, Dhammi Ish K, Maheshwari Aditya V, Ray Ruma

机构信息

Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India 110095.

出版信息

Spine J. 2007 Mar-Apr;7(2):249-53. doi: 10.1016/j.spinee.2006.04.021.

DOI:10.1016/j.spinee.2006.04.021
PMID:17321978
Abstract

BACKGROUND CONTEXT

Pseudoaneurysm of the aorta in association with vertebral tuberculosis is a rare phenomenon. With the resurgence of human immunodeficiency virus (HIV) and associated resistant tuberculosis, this life-threatening complication requires greater awareness.

PURPOSE

Our purpose is to report the rare presentation and successful management of tubercular pseudoaneurysm of the aorta in association with vertebral tuberculosis, and to highlight the clinicoradiological features for early and prompt diagnosis of this potentially fatal, but treatable, disease.

STUDY DESIGN

A single case report and overview of the disease comprises the design of this study.

PATIENT SAMPLE

The patient, already surgically intervened, is a 27-year-old male with increasing abdominal and back pain, upper motor neuron signs, and constitutional signs and symptoms.

OUTCOME MEASURES

At 33 months follow-up, there is complete resolution of the signs and symptoms, and the patient is back to his previous vocation.

METHODS

The diagnosis was confirmed by magnetic resonance imaging and contrast computed tomography. Endoaneurysmorrhaphy of the pseudoaneurysm along with a complete course of antitubercular treatment was given to the patient, and he has presently been followed up for 33 months.

RESULTS

The patient's signs and symptoms have been completely resolved without any recurrence.

CONCLUSION

Despite the use of modern chemotherapy and imaging techniques, this disastrous complication still occurs and reinforces the need for early suspicion, diagnosis, surgical resection, and antitubercular therapy along with close postoperative follow-up to prevent recurrence. With the resurgence of HIV (and other immunocompromised states) associated and resistant tuberculosis, we should be more alert than ever to this life-threatening complication.

摘要

背景

主动脉假性动脉瘤合并脊柱结核是一种罕见现象。随着人类免疫缺陷病毒(HIV)的再度流行及相关耐药结核病的出现,这种危及生命的并发症需要引起更多关注。

目的

我们的目的是报告主动脉结核性假性动脉瘤合并脊柱结核这一罕见病例的表现及成功治疗情况,并强调这种潜在致命但可治疗疾病的临床放射学特征,以便早期及时诊断。

研究设计

本研究采用单病例报告及疾病概述的设计。

患者样本

该患者已接受手术干预,是一名27岁男性,有腹部和背部疼痛加剧、上运动神经元体征以及全身症状和体征。

观察指标

随访33个月时,症状和体征完全消失,患者恢复了之前的工作。

方法

通过磁共振成像和增强计算机断层扫描确诊。对患者进行了假性动脉瘤内缝术并给予全程抗结核治疗,目前已对其随访33个月。

结果

患者的症状和体征已完全消失,无任何复发。

结论

尽管使用了现代化疗和成像技术,但这种灾难性并发症仍会发生,这进一步凸显了早期怀疑、诊断、手术切除、抗结核治疗以及密切术后随访以预防复发的必要性。随着与HIV(及其他免疫功能低下状态)相关的耐药结核病再度出现,我们应比以往任何时候都更加警惕这种危及生命的并发症。

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