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伴有Crowe IV型发育性髋关节发育不良的假性动脉瘤:病例报告

Pseudoaneurysm Accompanied by Crowe Type IV Developmental Dysplasia of the Hip: A Case Report.

作者信息

Yo Hirotake, Ohashi Hirotsugu, Inori Fumiaki, Okajima Yoshiaki, Matsui Yoshio, Shintani Kosuke

机构信息

Department of Orthopedic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kita-ku, Osaka 530-0012, Japan.

出版信息

Case Rep Orthop. 2012;2012:973489. doi: 10.1155/2012/973489. Epub 2012 May 8.

Abstract

We report the case of a 72-year-old woman whose pseudoaneurysm was difficult to diagnose and treat. The patient had a history of congenital dislocated hip and was undergoing anticoagulation therapy with warfarin due to the mitral valve replacement. Her chief complaint was pain and enlargement of the left buttock, and the laboratory tests revealed severe anemia. However, her elderly depression confused her chief complaint, and she was transferred to a psychiatric hospital. Two months after the onset of the symptoms, she was finally diagnosed with a pseudoaneurysm by contrast-enhanced CT and angiography. IDC coils were used for embolization. A plain CT showed hemostasis as well as a reduced hematoma at 2 months after the embolization. The possible contributing factors for the pseudoaneurysm included bleeding due to warfarin combined with an intramuscular hematoma accompanied by Crowe type IV developmental dysplasia of the hip that led to an arterial rupture by impingement between pelvis and femoral head. Since the warfarin treatment could not be halted due to the valve replacement, embolization was chosen for her treatment, and the treatment outcome was favorable.

摘要

我们报告了一例72岁女性患者,其假性动脉瘤难以诊断和治疗。该患者有先天性髋关节脱位病史,因二尖瓣置换正在接受华法林抗凝治疗。她的主要诉求是左臀部疼痛和肿大,实验室检查显示严重贫血。然而,她的老年抑郁症使她的主要诉求变得模糊,她被转至一家精神病医院。症状出现两个月后,最终通过增强CT和血管造影诊断为假性动脉瘤。使用IDC线圈进行栓塞。栓塞术后2个月的平扫CT显示止血以及血肿缩小。假性动脉瘤的可能促成因素包括华法林导致的出血,合并伴有Crowe IV型髋关节发育不良的肌内血肿,后者导致骨盆与股骨头之间的撞击引起动脉破裂。由于瓣膜置换无法停用华法林治疗,因此选择栓塞治疗她的疾病,治疗效果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3431/3505917/f9fb6de349b6/CRIM.ORTHOPEDICS2012-973489.001.jpg

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