针对源自右锁骨下动脉的、导致咯血的扩展性霉菌性假性动脉瘤的紧急救援手术。
Emergent rescue operation for expanding mycotic pseudoaneurysm causing hemoptysis, originating from right subclavian artery.
作者信息
Mukaihara Kosuke, Yamamoto Hiroyuki, Arata Kenichi, Ueno Takayuki, Imoto Yutaka, Sakata Ryuzo
机构信息
Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Kagoshima, Japan.
Department of cardiovascular surgery, National Hospital Organization Kagoshima Medical Center, Kagoshima, Kagoshima, Japan.
出版信息
Ann Vasc Dis. 2015;8(1):62-5. doi: 10.3400/avd.cr.14-00116. Epub 2015 Mar 9.
Mycotic pseudoaneurysm of the subclavian artery is uncommon and its therapeutic strategy has not been established. We report a case of 81-year-old woman with mycotic pseudoaneurysm in the right subclavian artery. Blood culture showed Enterobacter cloacae. Because of hemoptysis and acute expansion of the pseudoaneurysm, emergent coil embolization was performed, but failed. The patient underwent urgent operation for an en-bloc resection of the pseudoaneurysm after aorto-right common carotid artery bypass followed by omentum packing. The patient underwent continuous wound irrigation for 3 weeks. The postoperative course was uneventful and without recurrence of infection.
锁骨下动脉霉菌性假性动脉瘤并不常见，其治疗策略尚未确立。我们报告一例81岁女性右锁骨下动脉霉菌性假性动脉瘤病例。血培养显示阴沟肠杆菌。由于咯血和假性动脉瘤急性扩张，进行了紧急弹簧圈栓塞，但失败了。患者在主动脉-右颈总动脉旁路移植术后紧急手术，整块切除假性动脉瘤，随后用网膜填塞。患者持续伤口冲洗3周。术后过程顺利，无感染复发。
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