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一种罕见的急性肾功能不全的病因:主动脉腔静脉瘘破裂。

Cause of a rare acute renal insufficiency: rupture aortocaval fistula.

作者信息

Simsek Erdal, Caliskan Aytac, Tutun Ufuk, Sahin Serpil

机构信息

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.

出版信息

Vascular. 2014 Aug;22(4):290-2. doi: 10.1177/1708538113493418. Epub 2013 Jun 18.

Abstract

INTRODUCTION

Abdominal aortic aneurysms can be complicated by some conditions and aortocaval fistula is one of them. Aortocaval fistula is an unusual entity.

CASE REPORT

A male patient was admitted to the hospital for abdominal pain and leg oedema of three days duration. In addition, severe anuria was also noted. We determined a fistula from the right lateral wall of aneurysm to the distal of vena cava inferior. The aortocaval fistula was closed with pledged-reinforced 4/0 polypropylene suture in the aneurysmal wall. At the postoperative 10th day, he was discharged with normal renal function.

DISCUSSION

After a long-term untreated fistula, right-sided heart failure, acute renal and hepatic insufficiency, deep vein thrombosis and pulmonary thrombo-embolism can be seen in these patients. Increased venous pressure should be the reason for decreased arterial flow results in renal insufficiency. Emergency intervention in these patients saves the patient's life as well as prevents irreversible organ failure.

摘要

引言

腹主动脉瘤可并发某些病症,主动脉腔静脉瘘便是其中之一。主动脉腔静脉瘘是一种罕见的病症。

病例报告

一名男性患者因持续三天的腹痛和腿部水肿入院。此外,还发现严重无尿。我们确定存在一个从动脉瘤右外侧壁至下腔静脉远端的瘘管。在动脉瘤壁用带垫片加强的4/0聚丙烯缝线封闭主动脉腔静脉瘘。术后第10天,他肾功能正常出院。

讨论

长期未经治疗的瘘管患者可出现右侧心力衰竭、急性肾和肝功能不全、深静脉血栓形成和肺血栓栓塞。静脉压升高应是导致动脉血流减少进而引起肾功能不全的原因。对这些患者进行紧急干预可挽救患者生命并防止不可逆的器官衰竭。

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