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[1例腹主动脉瘤重建术后并发白塞病的主动脉肠瘘病例,并特别提及日本报道的95例病例]

[A case of aorto-enteric fistula after reconstruction of an abdominal aortic aneurysm associated with Behçet's disease and special reference to 95 reported cases in Japan].

作者信息

Koike S, Matsumoto K, Kokubo M, Mori Y, Murakawa S, Hirose M

机构信息

First Department of Surgery, Gifu University School of Medicine, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Jun;89(6):945-51.

PMID:3054476
Abstract

A 45-year-old male with incomplete type of Behçet's disease was operated on because of abdominal aortic aneurysm. The post-operative course was uneventful. On twenty-one months after discharge, the patient noticed left leg pain and tarry stool, and was referred to our hospital. Computed tomography and angiography showed aorto-enteric fistula at the proximal aortic anastomotic site. Aortic reconstruction was performed, but the patient died on 36th post-operative day. We analysed the reports of 95 cases of aneurysm associated with vasculo-Behçet's disease in Japan. This series comprised 82 men, 9 women and 4 unknowns. The cases were classified to four groups, which were incomplete type (48 cases), complete type (27 cases), suspected type (12 cases) and unknown (8 cases). They had 46 aortic aneurysms and 108 peripheral aneurysms. Operation was performed on 29 aortic aneurysms and 73 peripheral aneurysms. Eleven aortic aneurysms and twelve peripheral aneurysms had anastomotic complication post-operatively. Four cases after reconstruction of abdominal aortic aneurysm was complicated with aorto-enteric fistula. They were all dead post-operatively. Vasculo-Behçet's disease with aortic aneurysm is comparatively a rare entity and morbidity and mortality is high because of its etiological characteristics.

摘要

一名45岁的不完全型白塞病男性因腹主动脉瘤接受了手术。术后过程顺利。出院21个月后,患者出现左腿疼痛和柏油样便,遂转诊至我院。计算机断层扫描和血管造影显示主动脉近端吻合部位存在主动脉肠瘘。进行了主动脉重建,但患者在术后第36天死亡。我们分析了日本95例与血管性白塞病相关的动脉瘤病例报告。该系列包括82名男性、9名女性和4名性别未知者。病例分为四组,即不完全型(48例)、完全型(27例)、疑似型(12例)和未知型(8例)。他们有46个主动脉瘤和108个周围动脉瘤。对29个主动脉瘤和73个周围动脉瘤进行了手术。11个主动脉瘤和12个周围动脉瘤术后出现吻合口并发症。4例腹主动脉瘤重建术后并发主动脉肠瘘。他们均于术后死亡。血管性白塞病合并主动脉瘤相对罕见,由于其病因特点,发病率和死亡率较高。

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