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白塞病患者髂动脉残端动脉瘤破裂合并主动脉假性动脉瘤

Ruptured iliac artery stump aneurysm combined with aortic pseudoaneurysm in a patient with Behçet's disease.

作者信息

Kim Hyung-Kee, Choi Hyang Hee, Huh Seung

机构信息

Division of Transplantation and Vascular Surgery, Department of Surgery, Kyungpook National University School of Medicine, Daegu, South Korea.

出版信息

Ann Vasc Surg. 2010 Feb;24(2):255.e5-8. doi: 10.1016/j.avsg.2009.07.012. Epub 2009 Nov 20.

Abstract

Operative treatment of aneurysm in patients with Behçet's disease frequently results in recurrent aneurysm at the anastomosis site or in the remaining artery. Herein, in a Behçet's patient with aortic and iliac pseudoaneurysms, a ruptured iliac artery stump aneurysm after ligation of the right external iliac artery 1 year prior to this admission is reported. This case suggests that the ligation or interposition of aneurysms associated with Behçet's disease should be done at the intact artery, remote to the diseased segment. In addition, a small pseudoaneurysm of the aorta could be monitored with close follow-up with immunosuppressive medication and surveillance at regular intervals if the aneurysm is not symptomatic and is not rapidly growing to a certain critical size.

摘要

白塞病患者动脉瘤的手术治疗常常导致吻合口部位或剩余动脉出现复发性动脉瘤。在此,报告一例患有主动脉和髂动脉假性动脉瘤的白塞病患者,此次入院前1年因右侧髂外动脉结扎后出现髂动脉残端动脉瘤破裂。该病例提示,与白塞病相关的动脉瘤结扎或血管移植应在远离病变节段的正常动脉处进行。此外,如果主动脉小假性动脉瘤无症状且未迅速增大至一定临界大小,可通过免疫抑制药物密切随访及定期监测进行观察。

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