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腹部主动脉和髂动脉瘤表现为下肢深静脉血栓形成:病例报告。

Abdominal aortic and iliac aneurysm presented as lower limb deep vein thrombosis: case report.

机构信息

Vascular surgery, University hospital Merkur, Zagreb, Croatia.

GH Bjelovar, Bjelovar, Croatia.

出版信息

Acta Chir Belg. 2020 Aug;120(4):271-273. doi: 10.1080/00015458.2018.1538282. Epub 2018 Nov 13.

Abstract

We report a rare case of a symptomatic abdominal aneurysm presented as a lower limb deep vein thrombosis (DVT). A 63-year old male presented to our hospital with a recent progressive onset of the right lower limb swelling and pain. The patient had a history of a previous cardiovascular disease. A Duplex ultrasound was performed, which confirmed a right lower limb DVT extending to the right iliac vein. The patient had a pulsatile abdominal mass. Computed tomography scan of the abdomen showed an abdominal aortic and a right iliac artery aneurysm compressing the thrombosed inferior caval and the right iliac vein. The patient was treated with low molecular weight heparin. After resolution of the DVT on day 3 of hospitalization, a surgery on the abdominal and iliac artery aneurysm was performed. The aneurysm was resected and an aortobifemoral bypass was placed using a Dacron prosthesis. The patient remained to be asymptomatic for 6 months after the surgery. Follow up computed tomography demonstrated a fully patent inferior caval and iliac vein and the absence of the aneurysmal disease. Although rare, our case confirms that the DVT should be considered as a possible symptom of an abdominal aneurysm in selected patients.

摘要

我们报告了一例罕见的以下肢深静脉血栓形成(DVT)为表现的症状性腹主动脉瘤。一名 63 岁男性因右下肢肿胀和疼痛进行性加重而就诊于我院。患者有既往心血管疾病病史。行双下肢超声检查,证实右下肢 DVT 延伸至右髂静脉。患者有搏动性腹部肿块。腹部 CT 扫描显示腹主动脉和右髂动脉动脉瘤压迫血栓形成的下腔静脉和右髂静脉。患者接受了低分子肝素治疗。入院第 3 天 DVT 缓解后,对腹主动脉和髂动脉动脉瘤进行了手术。切除了动脉瘤,并使用涤纶假体进行了主动脉-股动脉旁路移植术。手术后 6 个月,患者仍无症状。随访 CT 显示下腔静脉和髂静脉完全通畅,无动脉瘤病变。虽然罕见,但我们的病例证实,在某些患者中,DVT 应被视为腹主动脉瘤的可能症状之一。

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