George Jayan, Nathani Harsh, Hu Andrew, Al-Mukhtar Ahmed
Department of Hepatobiliary Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
BMJ Case Rep. 2017 Feb 20;2017:bcr2016218182. doi: 10.1136/bcr-2016-218182.
We describe a case of a 59-year-old man with no significant medical history apart from a hiatus hernia and depression who presented with periumbilical pain which woke him at night. Before this he had 6 weeks of generalised abdominal pain. Blood tests were relatively normal and CT revealed some ill-defined stranding around the coeliac artery. He was diagnosed with a spontaneous coeliac artery dissection. Given the complexity of the case, a multidisciplinary team approach was adopted. He was managed conservatively and improved significantly over the next few days. Further investigations confirmed ischaemic changes to the distal duodenum and proximal jejunum. He has since been followed-up with CT scans and has had no further episodes 12 months from his initial admission.
我们描述了一例59岁男性病例，除了食管裂孔疝和抑郁症外无其他重要病史，该患者因脐周疼痛于夜间醒来就诊。在此之前，他有6周的全腹疼痛。血液检查相对正常，CT显示腹腔干周围有一些边界不清的条索状影。他被诊断为自发性腹腔干夹层。鉴于该病例的复杂性，采用了多学科团队的方法。他接受了保守治疗，在接下来的几天里有明显改善。进一步检查证实十二指肠远端和空肠近端有缺血性改变。自首次入院12个月以来，他一直通过CT扫描进行随访，未再出现发作。
