成功治疗的无症状性腹腔干动脉瘤：一例报告。
Successfully-treated asymptomatic celiac artery aneurysm: A case report.
作者信息
Takeuchi Nobuhiro, Soneda Junichi, Naito Hiromichi, Iida Atsuyoshi, Yumoto Tetsuya, Tsukahara Kohei, Nakao Atsunori
机构信息
Department of Internal Medicine, Kobe Tokushukai Hospital, Tarumi, Kobe, Japan.
Department of Critical Care and Emergency Medicine, Okayama University Hospital, Okayama, Japan.
出版信息
Int J Surg Case Rep. 2017;33:115-118. doi: 10.1016/j.ijscr.2017.02.018. Epub 2017 Feb 27.
BACKGROUND
Celiac artery aneurysm is a rare vascular lesion. It is frequently discovered after rupture, which leads to death in most cases. We present a case of an asymptomatic celiac artery aneurysm discovered in a 72-year-old female during an evaluation for high grade fever and general fatigue.
CASE PRESENTATION
The patient visited our department with complaints of fever and general fatigue. The patient's medical history included type 2 diabetes mellitus with poor control and hypertension. Blood culture and urine culture that were submitted at arrival presented E. Coli. Then, she was diagnosed with bacteremia by urinary tract infection. Transesophageal echocardiography revealed no vegetation at her valves. Computed tomography was performed for investigating her urological abnormalities, revealing a 28×30 mm aneurysm at the trunk of the celiac artery. Blood and urine cultures submitted at arrival were positive for E. coli. Surgical repair performed after the improvement of her urinary tract infection revealed a non-infective aneurysm; thus, aneurysm closure and prosthetic grafting were conducted.
CONCLUSION
Clinician awareness regarding this rare entity and discovery efforts to discover the splanchnic aneurysm before rupturing are imperative.
背景
腹腔干动脉瘤是一种罕见的血管病变。它常在破裂后被发现，多数情况下会导致死亡。我们报告一例72岁女性在因高热和全身乏力接受评估时发现的无症状腹腔干动脉瘤病例。
病例介绍
患者因发热和全身乏力前来我院就诊。患者既往病史包括控制不佳的2型糖尿病和高血压。入院时送检的血培养和尿培养结果显示为大肠杆菌。随后，她被诊断为尿路感染所致的菌血症。经食管超声心动图检查显示其瓣膜无赘生物。为排查泌尿系统异常进行了计算机断层扫描，结果显示腹腔干主干有一个28×30毫米的动脉瘤。入院时送检的血培养和尿培养结果大肠杆菌呈阳性。在尿路感染病情改善后进行的手术修复显示为非感染性动脉瘤；因此，进行了动脉瘤封闭和人工血管移植术。
结论
临床医生必须提高对这种罕见疾病的认识，并努力在腹内脏器动脉瘤破裂前将其发现。
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