Nishimura Kengo, Hamasaki Takafumi, Ota Rikako, Matsuoka Yuki, Kodama Wataru, Fukino Syunsuke
Department of Vascular Surgery, Tottori Prefectural Kousei Hospital, Kurayoshi, Tottori, Japan.
Department of Thoracic Surgery, Tottori Prefectural Kousei Hospital, Kurayoshi, Tottori, Japan.
Int J Angiol. 2019 Mar;28(1):28-30. doi: 10.1055/s-0038-1676965. Epub 2019 Jan 11.
Deep femoral artery (DFA) aneurysms are rare. DFA is protected by the adductor canal, which may delay the diagnosis. Then, its early diagnosis may be difficult and it is possible to be misdiagnosis with incarcerated inguinal hernia, which occurs more often in elderly people. We report a very rare case of a treatment of an advanced elderly patient with an isolated ruptured DFA aneurysm that was preoperatively confused with an incarcerated inguinal hernia. A 97-year-old man was admitted to a neighboring hospital due to a painful mass of the right groin after transient consciousness loss and the patient was diagnosed with right incarcerated inguinal hernia by a nonenhanced computed tomography (CT). Although he was observed for 3 days, he suddenly lost consciousness again with a decrease in blood pressure. Thus, he was referred to our hospital due to the painful pulsatile inguinal mass after resuscitation from shock. As we diagnosed a ruptured DFA aneurysm by an enhanced CT, we emergently performed an excision of the aneurysm with revascularization of the right DFA. The postoperative course was uneventful without ischemic change of the lower leg.
股深动脉（DFA）动脉瘤较为罕见。DFA受收肌管保护，这可能会延迟诊断。因此，其早期诊断可能困难，且有可能被误诊为嵌顿性腹股沟疝，后者在老年人中更为常见。我们报告一例极为罕见的病例，即对一名高龄患者的孤立性破裂DFA动脉瘤进行治疗，该动脉瘤术前被误诊为嵌顿性腹股沟疝。一名97岁男性因短暂意识丧失后右侧腹股沟出现疼痛性肿块入住附近医院，经非增强计算机断层扫描（CT）诊断为右侧嵌顿性腹股沟疝。尽管对其观察了3天，但他突然再次失去意识且血压下降。因此，在休克复苏后，因其腹股沟出现疼痛性搏动性肿块，他被转诊至我院。经增强CT诊断为破裂的DFA动脉瘤后，我们紧急进行了动脉瘤切除及右侧DFA血管重建术。术后病程平稳，小腿无缺血改变。
