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[心内膜炎并发肠系膜上动脉动脉瘤]

[Endocarditis complicated by an aneurysm of the superior mesenteric artery].

作者信息

Hatim E G A, Hachimi M-A, Madani H, Atmani N, Moutakillah Y, Bamous M, Abdou A, Drissli M, Aithoussa M, Wahid F-A, Boulahya A, Haimer C, Drissi Kamili N

机构信息

Service d'anesthésie-réanimation chirurgie cardiaque, hôpital militaire Mohammed V Hay Riad, 11000 Rabat, Maroc.

Service d'anesthésie-réanimation chirurgie cardiaque, hôpital militaire Mohammed V Hay Riad, 11000 Rabat, Maroc.

出版信息

Arch Pediatr. 2014 Jul;21(7):750-3. doi: 10.1016/j.arcped.2014.04.027. Epub 2014 Jun 16.

Abstract

Infective endocarditis (IE) is a rare, polymorphic disease in children. Mycotic aneurysm is a rare condition that complicates about 2.5 to 10% of cases of endocarditis. It is responsible for significant morbidity and mortality [1,2]. Mycotic aneurysms are often asymptomatic, physical examination is poor, but the diagnosis should be considered with the triad including fever, abdominal pain, and abdominal mass beating. Abdominal ultrasound and computed tomography are the most useful for the identification of the aneurysmal mass. However, angiography is an interesting addition to confirm the diagnosis and implement a treatment procedure [3]. The treatment of SMA aneurysms is largely surgical. IE treatment is based on antibiotic therapy combined with surgical repair. We report the case of a 15-year-old patient, first operated for an SMA aneurysm complicating the course of IE, who secondarily underwent mitral valve repair. We review the epidemiology, diagnosis, and care principles of mycotic aneurysms of the SMA.

摘要

感染性心内膜炎(IE)在儿童中是一种罕见的多形性疾病。霉菌性动脉瘤是一种罕见病症,约2.5%至10%的心内膜炎病例会并发该病症。它会导致显著的发病率和死亡率[1,2]。霉菌性动脉瘤通常无症状,体格检查效果不佳,但当出现发热、腹痛和腹部搏动性肿块这三联征时应考虑诊断。腹部超声和计算机断层扫描对识别动脉瘤性肿块最有用。然而,血管造影术对于确诊和实施治疗程序是一种有益的补充[3]。肠系膜上动脉(SMA)动脉瘤的治疗主要是手术治疗。IE的治疗基于抗生素治疗并结合手术修复。我们报告一例15岁患者,该患者首次因并发IE病程的SMA动脉瘤接受手术,随后又接受了二尖瓣修复术。我们回顾了SMA霉菌性动脉瘤的流行病学、诊断和护理原则。

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