Vogel Y, Keilmann O, Jochheim R, Tannapfel A
Abteilung für Innere Medizin, Klinik Blankenstein, Im Vogelsang 5-11, 45527, Hattingen, Germany.
Internist (Berl). 2010 Aug;51(8):1053-6. doi: 10.1007/s00108-009-2551-3.
A 73-year-old man was admitted to the hospital due to severe hematemesis and collapse, severe anemia and inflammation. Two months ago, the patient had been treated with antibiotics due to septicemia with staphylococcus aureus. At that time CT scan had shown only thoracic arteriosclerosis. The subsequent high urgency upper endoscopy identified a circular mucosal defect in distal esophagus as bleeding origin. The patient died 10 hours after admission. Performing autopsy, a fistula between the thoracic aortic aneurysm and the distal esophagus was found in the background of severe arteriosclerosis. The rapid onset of an aneurysm with rupture after a bacterial infection is typical for a mycotic aneurysm.
一名73岁男性因严重呕血、虚脱、严重贫血和炎症入院。两个月前，该患者因金黄色葡萄球菌败血症接受了抗生素治疗。当时的CT扫描仅显示胸段动脉硬化。随后的急诊上消化道内镜检查发现远端食管有一个圆形黏膜缺损，为出血源头。患者入院10小时后死亡。尸检发现，在严重动脉硬化的背景下，胸主动脉瘤与远端食管之间存在瘘管。细菌感染后动脉瘤迅速形成并破裂是真菌性动脉瘤的典型表现。
