急性胆囊炎后感染性增大的腹主动脉瘤。
An infected enlarging abdominal aortic aneurysm after acute cholecystitis.
作者信息
Hwang Sang Y, Clarke James M F, Tang Tjun Y
机构信息
Department of Vascular Surgery, Prince of Wales Hospital, Randwick, NSW, Australia; Prince of Wales Hospital Clinical School, University of New South Wales, Australia.
Department of Vascular Surgery, Norfolk and Norwich University Hospital, UK.
出版信息
Int J Surg Case Rep. 2014;5(5):237-9. doi: 10.1016/j.ijscr.2014.02.012. Epub 2014 Mar 12.
INTRODUCTION
An abdominal aortic aneurysm (AAA) infection is rare and can be difficult to manage, with high morbidity and mortality. We present a patient who suffered an infected AAA after undergoing a laparoscopic cholecystectomy and discuss the surgical management options.
PRESENTATION OF CASE
A 69-year-old male presents with a rapidly enlarging AAA 4 weeks following laparoscopic cholecystectomy. He was managed with open debridement, washout and repair of the aneurysm, but suffered ongoing sequelae of Escherichia coli sepsis.
DISCUSSION
The options for surgical management of infected AAA include open, endovascular and combined approaches. Recent papers report successful use of endovascular repair of infected AAAs but this is an ongoing area of research.
CONCLUSION
Infection of an AAA is associated with high mortality and long-term morbidity and requires optimal treatment. Surgical options include open debridement and repair, endovascular aneurysm repair (EVAR) or a combined approach.
引言
腹主动脉瘤（AAA）感染较为罕见，且难以处理，具有较高的发病率和死亡率。我们报告一例在接受腹腔镜胆囊切除术后发生感染性腹主动脉瘤的患者，并讨论手术治疗方案。
病例介绍
一名69岁男性在腹腔镜胆囊切除术后4周出现迅速增大的腹主动脉瘤。他接受了开放性清创、冲洗及动脉瘤修复治疗，但仍出现了大肠杆菌败血症的持续后遗症。
讨论
感染性腹主动脉瘤的手术治疗方案包括开放手术、血管腔内手术及联合手术。近期文献报道了血管腔内修复感染性腹主动脉瘤的成功案例，但这仍是一个正在研究的领域。
结论
腹主动脉瘤感染与高死亡率和长期发病率相关，需要进行最佳治疗。手术选择包括开放性清创和修复、血管腔内动脉瘤修复术（EVAR）或联合手术。
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