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下腔静脉瘤伴血胸:罕见表现。

Inferior vena cava aneurysm with hemothorax: rare presentation.

作者信息

Qaradaghi Lawand, Imren V Yildirim, Ereren Emrah, Tumer Naim Boran

机构信息

Department of Cardiovascular Surgery, Gazi University Hospital, Ankara, Turkey.

出版信息

Ann Vasc Surg. 2010 Aug;24(6):823.e11-4. doi: 10.1016/j.avsg.2010.02.019. Epub 2010 May 13.

Abstract

We presented a case of hemothorax secondary to inferior vena cava (IVC) aneurysm. A 47-year-old woman was presented to our hospital with nausea, vomiting, and right superior abdominal pain. There was pleural effusion on the right side of the posteroanterior chest x-ray for which a thoracentesis was performed and serohemorrhagic fluid was determined. Biochemical tests showed a mixed transudate and hemorrhage (hemothorax). Cytology was negative for malignancy. Computed tomography revealed a right-sided pleural effusion and a suprahepatic mass that was neighboring IVC and right atrium. Suprahepatic IVC aneurysm without venous obstruction was shown by magnetic resonance imaging and angiography. Mass was explored with right thoracotomy through sixth intercostal space, and the aneurysmal mass was seen and dissected from neighboring tissues. The mass was discrete and directly related to IVC just above the right hepatic vein entrance. After the excision of the aneurysm, the IVC wall was repaired. Histopathologic examination confirmed our diagnosis as venous aneurysm. The patient was discharged without any complication on the sixth postoperative day.

摘要

我们报告了一例继发于下腔静脉(IVC)动脉瘤的血胸病例。一名47岁女性因恶心、呕吐和右上腹疼痛就诊于我院。后前位胸部X线片显示右侧胸腔积液,为此进行了胸腔穿刺,确定为血清血性液体。生化检查显示为混合性漏出液和出血(血胸)。细胞学检查未发现恶性肿瘤。计算机断层扫描显示右侧胸腔积液和一个位于肝上的肿块,该肿块邻近下腔静脉和右心房。磁共振成像和血管造影显示肝上腔静脉动脉瘤且无静脉阻塞。通过第六肋间间隙行右胸切开术探查肿块,可见动脉瘤性肿块并将其与邻近组织分离。肿块是孤立的,直接与右肝静脉入口上方的下腔静脉相关。切除动脉瘤后,修复下腔静脉壁。组织病理学检查证实我们的诊断为静脉动脉瘤。患者术后第六天无任何并发症出院。

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