Vaidyanathan Sriram, Wadhawan Himanshu, Welch Pedro, El-Salamani Murad
Emergency Medicine, Bassetlaw District General Hospital, Nottinghamshire, UK.
CJEM. 2008 May;10(3):251-4. doi: 10.1017/s1481803500010186.
The rupture of an abdominal aortic aneurysm (AAA) is a catastrophic event. Misdiagnosis by first-contact emergency physicians remains a serious concern. Varied and frequently nonspecific presentations lead to erroneous diagnostic impressions and cause significant delays in definitive intervention. We report the case of a 73-year-old man with a ruptured AAA presenting with isolated acute right hip pain without any classical features such as truncal pain or hypotension. Despite major advances in imaging and definitive treatment, a heightened awareness among emergency physicians remains the only effective means of improving detection and thereby survival.
腹主动脉瘤(AAA)破裂是一种灾难性事件。首诊急诊医生的误诊仍是一个严重问题。其表现多样且常常不具有特异性,会导致错误的诊断印象,并造成确定性干预的显著延迟。我们报告一例73岁男性腹主动脉瘤破裂患者,其仅表现为急性右髋部疼痛,无任何诸如躯干疼痛或低血压等典型症状。尽管在影像学和确定性治疗方面取得了重大进展,但提高急诊医生的意识仍然是改善检测从而提高生存率的唯一有效方法。