Tang Haijun, Liu Yun, Moro Abu, Xiao Zengming, Zhan Xinli
Department of Spine and Osteopathic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning City, Guangxi Province, China.
J Infect Dev Ctries. 2019 Feb 28;13(2):174-178. doi: 10.3855/jidc.10707.
The increase in the incidence of tuberculosis in developing countries has resulted in increased reporting on more related complications. We report the successful management of an intraoperative spontaneous rupture of a tuberculous pseudo aneurysm associated with spinal tuberculosis.
We report the case of a 66 years old woman diagnosed with spinal tuberculosis of the T3/T4 vertebrae. During an anterior approach surgical reconstruction for the degenerative vertebrae, massive hemorrhage was observed after the removal of a portion of the prevertebral fascia of the affected vertebrae. This led to the exploration of the hilar fascia for the possibility of hilar hemorrhage, and when no hemorrhage was observed, aneurysm rupture was suspected. A portion of the hilar fascia was then sutured to the prevertebral fascia and the hemorrhage was partially controlled.
On the 32nd month post-operative follow-up, the symptoms of chest and back pain had disappeared and the tuberculous lesion eradicated.
Presently, there are few reports on the successful treatment of intraoperative spontaneous rupture of tuberculous pseudoaneurysms. We therefore report on the successful management of such a case.
发展中国家结核病发病率的上升导致了更多相关并发症报告的增加。我们报告了一例与脊柱结核相关的结核性假性动脉瘤术中自发性破裂的成功处理病例。
我们报告了一名66岁女性被诊断为T3/T4椎体脊柱结核的病例。在对退变椎体进行前路手术重建过程中，切除部分患椎的椎前筋膜后观察到大量出血。这促使对肺门筋膜进行探查以寻找肺门出血的可能性，当未观察到出血时，怀疑是动脉瘤破裂。然后将部分肺门筋膜缝合到椎前筋膜上，出血得到部分控制。
术后32个月随访时，胸背部疼痛症状消失，结核病灶得以根除。
目前，关于结核性假性动脉瘤术中自发性破裂成功治疗的报道较少。因此，我们报告了这样一例成功处理的病例。
