Zelikovski A, Gutman H, Friedman M, Haddad M
Vascular Surgery Unit, Beilinson Medical Center, Petah Tikva, Israel.
Isr J Med Sci. 1990 May;26(5):270-4.
Unusual presentations of aortoiliac aneurysms may be the reason for a delay in diagnosis of potentially life-threatening conditions. Five such unusual clinical pictures are presented and discussed. The aneurysms were falsely diagnosed as malignant disease, renal colic, sciatic syndrome, intra-abdominal bleeding of unknown origin, and psoas muscle abscess. The medical staff was misled by the atypical complaints, signs and symptoms, which resulted in a dangerous delay in diagnosis. The use of currently available ultrasonography and CAT scans, which enables early diagnosis, depends on the alertness of clinicians when they confront an atypical clinical picture that may be the first clue of a noninnocent aneurysm of the aortoiliac complex. Early surgical intervention before dissection, rupture or fistulization occur ensures a positive outcome and avoids emergency procedures with their attendant high operative mortality and postoperative morbidity.
腹主动脉髂动脉瘤的不典型表现可能是导致对潜在危及生命疾病诊断延迟的原因。本文介绍并讨论了五种此类不典型临床表现。这些动脉瘤曾被误诊为恶性疾病、肾绞痛、坐骨神经综合征、不明原因的腹腔内出血以及腰大肌脓肿。医务人员被非典型的主诉、体征和症状误导,导致诊断出现危险的延迟。目前可用的超声检查和计算机断层扫描能够实现早期诊断,但这取决于临床医生在面对可能是腹主动脉髂复合体非良性动脉瘤首个线索的非典型临床表现时的警觉性。在动脉瘤夹层、破裂或形成瘘管之前进行早期手术干预可确保取得良好结果,并避免伴随高手术死亡率和术后发病率的急诊手术。