Klein Holger Jan, Becker Daniel, Rancic Zoran
Division of Cardiovascular Surgery, University Hospital Zurich, Switzerland.
Int J Surg Case Rep. 2016;18:1-4. doi: 10.1016/j.ijscr.2015.11.020. Epub 2015 Nov 27.
Ruptured abdominal aortic aneurysm (RAAA) can infrequently present as symptomatic groin hernia. This misleading form of presentation often leads to erroneous preoperative management resulting in poor survival.
Two patients with RAAA mimicking symptomatic groin hernia underwent different preoperative managements pointing out the importance of the principles of hypotensive haemostasis in the scope of this emergency scenario.
Computed Tomography Angiography (CTA) remains the recommended diagnostic tool-for both safe diagnosis of the ruptured aneurysm and precise preoperative planning. Endovascular aortic repair of the RAAA-if feasible-is the treatment of choice. This rare form of RAAA manifestation should call physicians attention-especially in patients with known abdominal aortic aneurysms in their preceding medical history.
腹主动脉瘤破裂(RAAA)很少表现为有症状的腹股沟疝。这种具有误导性的表现形式常常导致术前管理错误,从而导致生存率低下。
两名表现为有症状腹股沟疝的RAAA患者接受了不同的术前管理,凸显了在这种紧急情况下低血压止血原则的重要性。
计算机断层扫描血管造影(CTA)仍然是推荐的诊断工具——既用于安全诊断破裂的动脉瘤,也用于精确的术前规划。如果可行,RAAA的血管内主动脉修复是首选治疗方法。这种罕见的RAAA表现形式应引起医生的注意——尤其是对于既往病史中有腹主动脉瘤的患者。