Calligaro K D, Savarese R P, DeLaurentis D A
Section of Vascular Surgery, Pennsylvania Hospital/University of Pennsylvania School of Medicine, Philadelphia.
J Vasc Surg. 1990 Nov;12(5):586-90. doi: 10.1067/mva.1990.23414.
Three unusual cases of an abdominal aortic aneurysm spontaneously rupturing into the retroperitoneum and an adherent posterior vein are reported. No patient demonstrated signs or symptoms of an aortovenous fistula before surgery. Emergent surgery prevented extensive preoperative diagnostic testing. The three abdominal aortic aneurysms were very large and averaged 13 cm in diameter. One fistula involved an inflammatory aneurysm, which is the fifth such case reported. The aortic fistulas were to the inferior vena cava (158 other cases reported in the English-language literature), a left renal vein (16 other cases reported), and an iliac vein (7 other cases reported). Routine use of the cell-saver, oversewing of the fistula from within the aneurysm, and a heightened awareness that this unusual complication is more common in the presence of a very large, ruptured abdominal aortic aneurysm should improve survival.
报告了三例腹主动脉瘤自发破裂至腹膜后并与一条粘连的后静脉相通的罕见病例。术前无患者表现出主动脉静脉瘘的体征或症状。急诊手术避免了广泛的术前诊断检查。这三个腹主动脉瘤都非常大，平均直径为13厘米。其中一个瘘口涉及炎性动脉瘤，这是报告的第五例此类病例。主动脉瘘分别通向腔静脉（英文文献中另有158例报告）、左肾静脉（另有16例报告）和髂静脉（另有7例报告）。常规使用细胞回收器、从动脉瘤内部缝合瘘口，以及提高对这种罕见并发症在巨大破裂腹主动脉瘤中更常见的认识，应能提高生存率。
