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腹腔干孤立性夹层的介入治疗:一例报告及文献复习

Interventional treatment of isolated dissection of the celiac artery: A case report and literature review.

作者信息

Wang Hai-Tao, Yu Zhi-Hai, Tu Can, Lu Bin

机构信息

Department of Vascular Intervention, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(24):e11026. doi: 10.1097/MD.0000000000011026.

Abstract

RATIONALE

Isolated dissection of the celiac artery (IDCA) is one of isolated visceral artery dissection, which can occur alone, and can also be complicated with superior mesenteric artery dissection and splenic artery pseudoaneurysm. This disease is very rare in clinic. The exact pathogenesis of IDCA remains unknown. At present, no consensus has yet been reached on the best treatment strategy for this rare disease. In the present study, the clinical data of one IDCA patient diagnosed and treated in our hospital was retrospectively analyzed, and related literatures were reviewed, in order to improve the understanding of the disease.

PATIENT CONCERNS

The patient was a 49-year-old male, who was admitted in our hospital because of "pain of subxyphoid area for one month". One month before, the patient presented with persistent pain in the subxyphoid area after he had a cold, on paroxysmal exacerbation occurred. After taking "stomach drug", the subjective symptoms eased slightly, but the disease attacked again two hours later.

DIAGNOSES

The patient was diagnosed with "isolated dissection of the celiac artery" by enhanced CT.

INTERVENTIONS

The patient was interventionally treated with bare stent implantation.

OUTCOMES

The symptom of the patient disappeared after interventional therapy.

LESSONS

In the present study, the clinical symptoms and treatment process of one patient with IDCA were described. The clinical symptoms of IDCA are often atypical, and its incidence is extremely low, therefore it is extremely easily misdiagnosed. The definite diagnosis depends on imaging examination. Interventional therapy is the first choice for treating this disease due to its advantages of small trauma and good curative effect.

摘要

理由

腹腔干孤立性夹层(IDCA)是孤立性内脏动脉夹层之一,可单独发生,也可合并肠系膜上动脉夹层和脾动脉假性动脉瘤。该疾病在临床上非常罕见。IDCA的确切发病机制尚不清楚。目前,对于这种罕见疾病的最佳治疗策略尚未达成共识。在本研究中,回顾性分析了我院诊断治疗的1例IDCA患者的临床资料,并复习相关文献,以提高对该疾病的认识。

患者情况

患者为49岁男性,因“剑突下区疼痛1个月”入院。1个月前,患者感冒后出现剑突下区持续性疼痛,呈阵发性加重。服用“胃药”后主观症状稍有缓解,但2小时后病情再次发作。

诊断

增强CT检查诊断为“腹腔干孤立性夹层”。

干预措施

对患者行裸支架植入介入治疗。

结果

介入治疗后患者症状消失。

经验教训

本研究描述了1例IDCA患者的临床症状及治疗过程。IDCA的临床症状常不典型,发病率极低,极易误诊。明确诊断依赖影像学检查。介入治疗因其创伤小、疗效好等优点,是治疗该疾病的首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b50/6024248/2625631c6198/medi-97-e11026-g001.jpg

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