Department of Emergency Medicine, Cathay General Hospital, Taipei, Taiwan.
Am J Emerg Med. 2013 Jun;31(6):1000.e3-5. doi: 10.1016/j.ajem.2013.02.007. Epub 2013 Mar 1.
Epigastralgia is a common chief compliant in the emergency department. Most of them are not fetal events, but some are life threatening such as aortic dissection or abdominal aneurysm rupture. Spontaneous visceral artery dissection is an uncommon occurrence with an unpredictable natural history and is rarely considered in the diagnosis of acute abdominal pain; however, it is as critical as aortic dissection and even easier to be ignored because of its rarity. We present a case of a 48-year-old man who presented to our emergency department with the chief concern of epigastric pain and diagnosed as having isolated spontaneous celiac artery dissection involving the hepatic artery, gastroduodenal artery, and splenic artery. Most cases required surgical intervention in previous reports; there are some, as in this case, managed well nonoperatively.
上腹痛是急诊科常见的主要症状。大多数不是胎儿事件,但有些是危及生命的,如主动脉夹层或腹主动脉瘤破裂。自发性内脏动脉夹层是一种罕见的疾病,具有不可预测的自然病史,在急性腹痛的诊断中很少被考虑;然而,它与主动脉夹层一样关键,甚至更容易被忽视,因为它很罕见。我们报告了一例 48 岁男性,因上腹痛就诊于我院急诊科,诊断为孤立性自发性腹腔动脉夹层,累及肝动脉、胃十二指肠动脉和脾动脉。既往报道中大多数病例需要手术干预;也有一些病例,如本例,非手术治疗效果良好。