Zhang Suqiao, Lian Rui, Zhang Guoqiang
Department of Emergency Medicine, China-Japan Friendship Hospital, Beijing, China.
Medicine (Baltimore). 2018 Jun;97(24):e11126. doi: 10.1097/MD.0000000000011126.
Penetrating aortic ulcer (PAU) and rupture of a superior mesenteric artery branch is a rare but potentially life-threatening condition.
We describe a case of 73-year-old man was brought to our Emergency Department for intermittent back pain.
The final diagnoses are PAU (Stanford B) and rupture of a branch of the superior mesenteric artery.
Two covered stents were placed in the thoracic aorta and the right external iliac artery, and the superior mesenteric artery branch was embolized. The patient subsequently underwent exploratory laparotomy, where 6000 to 7000mL of intra-abdominal hematoma was evacuated.
After the operation, the patient recovered smoothly and was discharged 20 days later. During 3-year follow-up, the patient did not develop any pain or discomfort.
Acute aortic syndrome (AAS) and acute coronary syndrome (ACS) may be difficult to distinguish, particularly for elderly patients with extensive atherosclerotic disease. Antithrombotic agent administration should be carefully considered.
穿透性主动脉溃疡（PAU）合并肠系膜上动脉分支破裂是一种罕见但可能危及生命的疾病。
我们描述了一名73岁男性因间歇性背痛被送至我院急诊科的病例。
最终诊断为PAU（斯坦福B型）和肠系膜上动脉分支破裂。
在胸主动脉和右髂外动脉置入了两个覆膜支架，并对肠系膜上动脉分支进行了栓塞。患者随后接受了剖腹探查术，术中清除了6000至7000毫升的腹腔内血肿。
术后患者恢复顺利，20天后出院。在3年的随访期间，患者未出现任何疼痛或不适。
急性主动脉综合征（AAS）和急性冠状动脉综合征（ACS）可能难以区分，尤其是对于患有广泛动脉粥样硬化疾病的老年患者。应谨慎考虑抗血栓药物的使用。
