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一名男性患者因鱼骨导致主动脉弓假性动脉瘤:病例报告。

A fish bone induced aortic arch pseudoaneurysm in a male patient: A case report.

作者信息

Wang Azhen, Zhou Yun, Huang Qilin

机构信息

Department of Critical Care Medicine.

Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Medicine (Baltimore). 2019 Jul;98(29):e16486. doi: 10.1097/MD.0000000000016486.

Abstract

RATIONALE

Esophageal foreign body is a commonly seen in China. However, pseudoaneurysm of the aortic arch caused by ingestion of fish bones is a rare, life-threatening condition.

PATIENT CONCERNS

A 71-year-old male was admitted to the Ear, Nose, and Throat department with a 4-day history of chest pain after eating fish.

DIAGNOSES

After taking out the fish bone by rigid endoscopy, magnetic resonance imaging and computerized tomography angiography (CTA) scans revealed the presence of an aortic arch pseudoaneurysm, which was likely caused by the fish bone.

INTERVENTIONS

A successful endovascular graft exclusion surgery was performed to block the aorta ulcer.

OUTCOMES

The patient recovered and was discharged 20 days after hospitalization. The patient was healthy and had no fever or chest pain 4 months after discharge from the hospital.

LESSONS

Esophageal foreign bodies may lead to life-threatening impairment of the aorta or other big arteries. When esophageal foreign bodies puncture the esophageal wall, especially in the second stenosis of the esophagus, an enhanced-contrast computed tomography scan or a CTA scan may be necessary to exclude any potential impairment of the arteries.

摘要

理论依据

食管异物在中国较为常见。然而,因吞食鱼骨导致的主动脉弓假性动脉瘤是一种罕见的、危及生命的情况。

患者情况

一名71岁男性因进食鱼类后胸痛4天入住耳鼻喉科。

诊断

通过硬式内镜取出鱼骨后,磁共振成像和计算机断层血管造影(CTA)扫描显示存在主动脉弓假性动脉瘤,很可能是由鱼骨所致。

干预措施

成功进行了血管内支架置入术以封堵主动脉溃疡。

结果

患者康复,住院20天后出院。出院4个月后,患者身体健康,无发热或胸痛症状。

经验教训

食管异物可能导致危及生命的主动脉或其他大动脉损伤。当食管异物刺穿食管壁时,尤其是在食管第二狭窄处,可能需要进行增强CT扫描或CTA扫描以排除动脉的任何潜在损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37fc/6709094/c161dd9de356/medi-98-e16486-g001.jpg

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