Hill J, Charlesworth D
Department of Surgery, University Hospital of South Manchester, West Didsbury, United Kingdom.
Ann Vasc Surg. 1988 Oct;2(4):352-7. doi: 10.1016/S0890-5096(06)60815-7.
Of a total of 780 patients with abdominal aortic aneurysms, 37 patients (4.7%) had inflammatory aneurysms. Presenting symptoms included back and abdominal pain (76%), leg edema, melena, uremia, claudication and pancreatitis. Mean erythrocyte sedimentation rate was 45 mm/hr. Weight loss and anorexia were common. Elevated urea and creatinine were seen on 11 patients, nine of whom had obstructive uropathy. Average aneurysm size was 9.3 cm. Thirty-six patients were treated surgically and one was observed. Involvement of the suprarenal (nine cases) or thoracic (three cases) aorta was common. Elective operations included resection and grafting in 21 patients and axillofemoral bypass in four patients. Patients with ureteral entrapment underwent simultaneous ureterolysis. Among the elective operations four deaths were noted (15%). Ten emergency operations were done for posterior rupture (four cases), aortoduodenal fistula (one case), inferior vena cava obstruction or fistula (two cases), hemorrhage into the aneurysmal wall (two cases), or presumed rupture (one case). There were seven deaths (70%) in this group. The operation of choice for inflammatory aneurysm is a bifurcation graft combined with ureterolysis.
在总共780例腹主动脉瘤患者中，37例（4.7%）患有炎性动脉瘤。主要症状包括背痛和腹痛（76%）、腿部水肿、黑便、尿毒症、跛行和胰腺炎。平均红细胞沉降率为45毫米/小时。体重减轻和厌食很常见。11例患者尿素和肌酐升高，其中9例患有梗阻性尿路病。动脉瘤平均大小为9.3厘米。36例患者接受了手术治疗，1例接受观察。肾上腺（9例）或胸段（3例）主动脉受累很常见。择期手术包括21例患者的切除和移植以及4例患者的腋股旁路手术。输尿管受压患者同时进行输尿管松解术。在择期手术中，有4例死亡（15%）。10例急诊手术分别用于后腹膜破裂（4例）、主动脉十二指肠瘘（1例）、下腔静脉梗阻或瘘（2例）、动脉瘤壁内出血（2例）或疑似破裂（1例）。该组有7例死亡（70%）。炎性动脉瘤的首选手术是分叉移植联合输尿管松解术。
