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一名青少年男性以腹痛为首发症状的大动脉炎:病例报告

Abdominal pain as the presenting symptom of Takayasu arteritis in an adolescent male: A case report.

作者信息

Yang Shaobo, Dong Kuiran, Zheng Shan

机构信息

Department of Surgery, Children's Hospital of Fudan University, Shanghai, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(26):e11326. doi: 10.1097/MD.0000000000011326.

Abstract

RATIONALE

Takayasu arteritis (TA) is a chronic granulomatous inflammation affecting the aorta and its main branches. The clinical symptoms are mainly due to arterial claudication and end-organ ischaemia. Abdominal pain is an uncommon manifestation of TA.

PATIENT CONCERNS

We present a rare case of TA in a 13-year-old boy who first presented with abdominal pain. An emergency aortic stent implantation and aneurysm embolization were performed, and the intra-operative diagnosis was aortic pseudoaneurysm.

DIAGNOSES

A consultation with the department of rheumatism determined that the diagnosis was Takayasu arteritis according to the medical history, physical examination and auxiliary examination results.

INTERVENTIONS

The patient was transferred to the department of rheumatism for treatment with prednisolone and cyclophosphamide.

OUTCOMES

Six months after the initial presentation, he was doing well clinically with no additional vascular involvement, and his blood pressure had been stabilized with oral antihypertensive drugs.

LESSONS

More detailed examinations of children with acute abdominal pain should be performed. Abdominal computed tomography (CT) should be administered, peripheral impulses and arterial bruits should be checked, and blood pressure among the four limbs should be monitored to rule out plausible emergencies such as an aneurysm caused by TA.

摘要

理论依据

大动脉炎(TA)是一种影响主动脉及其主要分支的慢性肉芽肿性炎症。临床症状主要归因于动脉间歇性跛行和终末器官缺血。腹痛是TA的一种不常见表现。

患者情况

我们报告一例罕见的13岁男孩大动脉炎病例,该男孩最初表现为腹痛。进行了急诊主动脉支架植入和动脉瘤栓塞术,术中诊断为主动脉假性动脉瘤。

诊断

根据病史、体格检查和辅助检查结果,风湿科会诊确定诊断为大动脉炎。

干预措施

患者转至风湿科,接受泼尼松龙和环磷酰胺治疗。

结果

初次就诊6个月后,他临床情况良好,无其他血管受累,口服降压药后血压已稳定。

经验教训

对于急性腹痛患儿应进行更详细的检查。应进行腹部计算机断层扫描(CT),检查外周脉搏和动脉杂音,并监测四肢血压,以排除大动脉炎所致动脉瘤等可能的急症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07bd/6039581/6c659f73f259/medi-97-e11326-g001.jpg

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