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缺血性胆囊穿孔:A型主动脉夹层的一种并发症。

Ischemic gall bladder perforation: a complication of type A aortic dissection.

机构信息

Division of Adult Cardiac Surgery, Sheikh Khalifa Medical City (managed by Cleveland Clinic), Abu Dhabi, United Arab Emirates.

出版信息

Ann Thorac Surg. 2013 Jun;95(6):e155-6. doi: 10.1016/j.athoracsur.2012.11.055.

Abstract

Malperfusion of end organs occurs in 20% to 40% patients with acute type A aortic dissection. Because irreversible ischemia is a time-dependent event, expedient diagnosis and treatment are necessary. We herein report successful surgical management of a patient with acute type A aortic dissection causing transient gut ischemia and a rare gall bladder perforation. We implemented one-stage surgical and laparoscopic management approach for the diagnosis and treatment. Increased awareness of this complication and appropriate use of available diagnostic tools may improve the outcome in similar patients. Patients with aortic dissection complicated by visceral ischemia require a prompt sequential and rational multidisciplinary approach for successful management.

摘要

终末器官灌注不良发生于 20% 至 40% 的急性 A 型主动脉夹层患者中。由于不可逆性缺血是一个时间依赖性事件,因此需要及时诊断和治疗。本文报告了一例急性 A 型主动脉夹层导致短暂性肠道缺血和罕见胆囊穿孔的成功手术治疗。我们采用了一站式手术和腹腔镜管理方法进行诊断和治疗。提高对这种并发症的认识并适当使用现有诊断工具可能会改善此类患者的预后。主动脉夹层合并内脏缺血的患者需要及时进行序贯和合理的多学科方法来成功管理。

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