Matsuoka Yoshinori, Hashizume Makoto
Department of Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Kyushu, Japan.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.09.2008.0947. Epub 2009 Apr 28.
Acute abdominal aortic thrombosis is a rare but potentially fatal condition. The patient was a 56-year-old man who developed lower back pain and arrived at our emergency room in a state of shock. He was alert, but could not move his legs. Cardiac echo revealed abnormal movement of the heart, and acute myocardial ischaemia was suspected as a differential diagnosis. Emergency coronary angiography and aortography together with percutaneous cardiopulmonary support were attempted. Both femoral arteries were punctured, but the guide wire could not be advanced from the bifurcation to the aorta. Heart stoppage occurred and lifesaving treatment was ineffective. A large thrombus from the abdominal aorta to both common iliac arteries was observed by aortography. To reduce mortality in acute abdominal aortic thrombosis, the disease must be recognised early based on clinical symptoms, followed by immediate contrast CT and surgical management by thrombectomy or re-establishment of the blood circulation.
急性腹主动脉血栓形成是一种罕见但可能致命的疾病。患者为一名56岁男性,出现下背部疼痛,以休克状态抵达我们的急诊室。他神志清醒,但双腿无法活动。心脏超声显示心脏运动异常,怀疑为鉴别诊断的急性心肌缺血。尝试进行急诊冠状动脉造影和主动脉造影以及经皮心肺支持。双侧股动脉均被穿刺,但导丝无法从分叉处推进至主动脉。发生心脏骤停,抢救治疗无效。主动脉造影显示从腹主动脉到双侧髂总动脉有一大块血栓。为降低急性腹主动脉血栓形成的死亡率,必须根据临床症状早期识别该病,随后立即进行增强CT检查,并通过血栓切除术或恢复血液循环进行手术治疗。