Goodman Kevin D, Sule Harsh P
Department of Emergency Medicine, Thomas Jefferson University & Hospitals, Philadelphia, PA 19106, USA.
J Emerg Med. 2013 Apr;44(4):757-9. doi: 10.1016/j.jemermed.2012.07.077. Epub 2013 Jan 10.
Spontaneous iliac artery dissection is a rare clinical entity, reported previously in pregnant patients in association with collagen vascular disease, and in cases of high-energy trauma or intensive activity in athletes.
To alert clinicians to the incidence of spontaneous iliac artery dissection in the absence of any risk factors.
We report a case of a 45-year-old man brought into the Emergency Department with severe lower abdominal pain. Computed tomography angiography revealed bilateral common iliac artery dissecting aneurysms with a dissection flap extending into the left internal iliac artery.
This case demonstrates that despite being a rare condition, in cases of acute lower abdominal, inguinal or lower back pain, even in the absence of risk factors and limb ischemia, emergency physicians should maintain a broad differential that includes intra-abdominal/pelvic vascular pathology such as iliac artery dissection.
自发性髂动脉夹层是一种罕见的临床病症，此前曾报道于患有胶原血管疾病的孕妇以及运动员发生高能创伤或剧烈活动的病例中。
提醒临床医生注意在无任何危险因素情况下自发性髂动脉夹层的发生率。
我们报告一例45岁男性因严重下腹痛被送入急诊科。计算机断层血管造影显示双侧髂总动脉夹层动脉瘤，夹层瓣延伸至左髂内动脉。
该病例表明，尽管此病罕见，但在急性下腹部、腹股沟或下背部疼痛的病例中，即使没有危险因素和肢体缺血，急诊医生也应保持广泛的鉴别诊断，包括腹内/盆腔血管病变，如髂动脉夹层。
