Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawacho, Ogaki, Gifu, Japan.
Surg Today. 2012 Oct;42(10):1001-4. doi: 10.1007/s00595-012-0175-z. Epub 2012 Apr 7.
Mycotic aneurysms located in the tibioperoneal trunk are extremely rare, with only a few cases reported in the literature. Because of their infrequency and clinical presentations mimicking other etiologies, clinicians generally do not arrive at the diagnosis until the diameter becomes large enough to detect pulsation. We herein report a case of a 52-year-old male with an aneurysm of the tibioperoneal trunk resulting from infective endocarditis. His early clinical presentation was acute compartment syndrome of unknown cause, and a fasciotomy was performed by orthopedists who did not recognize the underlying aneurysm. Later, enhanced computed tomography revealed that an irregularly shaped aneurysm existed in his right tibioperoneal trunk. After the sepsis was controlled with the use of systemic antibiotics, resection of the aneurysm was performed in advance of cardiac surgery. No clinical symptoms due to ischemia were observed without any revascularization. Postoperative computed tomography demonstrated fine enhancement of the peroneal and post-tibial arteries via collaterals.
位于胫腓干的真菌性动脉瘤极其罕见，文献中仅报道了少数几例。由于其罕见性和临床表现类似于其他病因，临床医生通常只有在直径增大足以检测到搏动时才做出诊断。我们在此报告一例由感染性心内膜炎引起的胫腓干动脉瘤的 52 岁男性患者。他的早期临床表现为原因不明的急性间隔综合征，骨科医生进行了筋膜切开术，但未能识别潜在的动脉瘤。后来，增强 CT 显示其右侧胫腓干存在形状不规则的动脉瘤。在使用全身抗生素控制脓毒症后，在心脏手术前进行了动脉瘤切除术。未观察到因缺血引起的任何临床症状，也未进行血运重建。术后 CT 显示通过侧支循环，腓动脉和后胫动脉有精细增强。
