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急诊科超声检查发现一例孤立性腹腔干夹层伴脾梗死病例。

A Case of Isolated Celiac Artery Dissection Accompanied by Splenic Infarction Detected by Ultrasonography in the Emergency Department.

作者信息

Emori Kazumasa, Takeuchi Nobuhiro, Soneda Junichi

机构信息

Department of Cardiovascular Surgery, Kobe Tokushukai Hospital, 1-3-10 Kamitakamaru, Tarumi-ku, Kobe-shi, Hyogo 655-0017, Japan.

出版信息

Case Rep Cardiol. 2016;2016:8608496. doi: 10.1155/2016/8608496. Epub 2016 Apr 11.

Abstract

A 46-year-old male with a history of hypertension visited the emergency department (ED) by ambulance complaining of sudden pain in the left side of his back. Ultrasonography (USG) performed at ED revealed splenic infarction along with occlusion and dissection of the celiac and splenic arteries without abdominal artery dissection. Contrast enhanced computed tomography (CT) revealed the same result. Consequently, spontaneous isolated celiac artery dissection (SICAD) was diagnosed. Because his blood pressure was high (159/70 mmHg), antihypertensive medicine was administered (nicardipine and carvedilol). After his blood reached optimal levels (130/80 mmHg), symptoms disappeared. Follow-up USG and contrast enhanced CT performed 8 days and 4 months after onset revealed amelioration of splenic infarction and improvement of the narrowed artery. Here, we report a case of SICAD with splenic infarction presenting with severe left-sided back pain and discuss the relevance of USG in an emergency setting.

摘要

一名有高血压病史的46岁男性因左侧背部突发疼痛,由救护车送往急诊科。急诊科进行的超声检查(USG)显示脾梗死,同时伴有腹腔干和脾动脉闭塞及夹层形成,但无腹主动脉夹层。增强计算机断层扫描(CT)显示了相同的结果。因此,诊断为自发性孤立性腹腔干动脉夹层(SICAD)。由于他的血压较高(159/70 mmHg),给予了降压药物(尼卡地平和卡维地洛)。在他的血压达到最佳水平(130/80 mmHg)后,症状消失。发病后8天和4个月进行的随访超声检查和增强CT显示脾梗死有所改善,狭窄动脉情况也有所改善。在此,我们报告一例伴有脾梗死的SICAD病例,该病例表现为严重的左侧背部疼痛,并讨论超声检查在急诊情况下的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4680/4842356/881e9b2c32ee/CRIC2016-8608496.001.jpg

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