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术后复发性腹主动脉假性动脉瘤的 Behcet 病中以不完全性肠梗阻为主要表现:1 例病例报告并文献复习。

Incomplete intestinal obstruction as the possible main complaint in Behcet's disease after surgery for recurrent abdominal aortic pseudoaneurysms: a case report and literature review.

机构信息

Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, 169 Dong'hu Road, Wuhan, 430071, Hubei, People's Republic of China.

出版信息

BMC Cardiovasc Disord. 2018 Dec 17;18(1):238. doi: 10.1186/s12872-018-0977-z.

Abstract

BACKGROUND

Behcet's disease (BD) is a systemic vasculitis characterized by oral and genital aphthosis, and ocular and skin lesions. The disease is involved in vascular, gastrointestinal, and central nervous systems. Vasculitis may exacerbate fatal problems, such as anastomotic pseudoaneurysms. If the mesenteric vessels are involved, severe abdominal symptoms such as intestinal obstruction may occur.

CASE PRESENTATION

This case report describes a young female patient who suffered from BD with recurrent abdominal aortic pseudoaneurysms, as well as deep venous thrombosis and subsequent complications of incomplete intestinal obstruction. This patient first underwent stent grafting, which was followed by rupture of two newly formed anastomotic pseudoaneurysms within six months. Emergency open surgical repair (OSR) was then performed on the ruptured pseudoaneurysms. Thrombosis and incomplete ileus occurred five months after surgery. This case was unique due to the presence of incomplete intestinal obstruction being the possible main complaint for a patient with Behcet's disease, and it is the first ever case to be reported.

CONCLUSION

Intestinal obstruction may present as the possible main complaint in BD. Careful and attentive strategy should be carried out to prevent fatal outcomes.

摘要

背景

贝赫切特病(BD)是一种全身性血管炎,其特征为口腔和生殖器阿弗他溃疡,以及眼部和皮肤损害。该疾病涉及血管、胃肠道和中枢神经系统。血管炎可能会使吻合口假性动脉瘤等致命问题恶化。如果肠系膜血管受累,可能会出现严重的腹部症状,如肠梗阻。

病例介绍

本病例报告描述了一位年轻女性患者,患有反复发作的腹主动脉假性动脉瘤、深静脉血栓形成以及随后发生不完全性肠梗阻的并发症。该患者首先接受了支架移植,随后在 6 个月内出现了两个新形成的吻合口假性动脉瘤破裂。破裂的假性动脉瘤随后进行了紧急开放手术修复(OSR)。术后 5 个月发生了血栓形成和不完全性肠梗阻。由于不完全性肠梗阻可能是贝赫切特病患者的主要主诉,因此该病例较为独特,而且这是首例报道。

结论

肠梗阻可能是 BD 的主要主诉。应采取谨慎和关注的策略,以防止出现致命后果。

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