Baskaran Dinnish, Ashraf Nadeem, Ahmad Adil, Menon Jay
Department of Accident and Emergency, North Middlesex Hospital, London, UK.
BMJ Case Rep. 2013 Sep 13;2013:bcr2013009150. doi: 10.1136/bcr-2013-009150.
The presentation of an abdominal aortic aneurysm (AAA) with isolated hip pain is a rare phenomenon. We present an atypical case of a 58-year-old previously fit man who presented with a 6-month history of progressively worsening left hip pain associated with unintentional weight loss, tender bilateral testicular swellings and a large non-tender palpable mass on abdominal examination. Urgent abdominal CT scan findings revealed a 15 cm infrarenal abdominal aortic aneurysm extending to the aortic bifurcation associated with an extensive left hydronephrosis. In theatre, the diagnosis of inflammatory AAA (IAAA) was confirmed following the presence of pyuria and a successful repair with an open approach using a bifurcated dacron graft was performed.
腹主动脉瘤(AAA)以孤立性髋关节疼痛为表现是一种罕见现象。我们报告一例非典型病例,患者为一名58岁既往健康男性,有6个月逐渐加重的左髋疼痛病史,伴有非刻意体重减轻、双侧睾丸压痛性肿大,腹部检查可触及一个大的无压痛肿块。紧急腹部CT扫描结果显示一个15厘米的肾下腹主动脉瘤延伸至主动脉分叉处,并伴有广泛的左肾积水。在手术室,发现脓尿后确诊为炎症性腹主动脉瘤(IAAA),并采用分叉涤纶移植物通过开放手术成功修复。