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颅外颈动脉霉菌性假性动脉瘤,一种严重罕见疾病,病例报告。

Mycotic pseudoaneurysm of the extracranial carotid artery, a severe and rare disease, a case report.

作者信息

Molina Gabriel, Mesías Carolina, Calispa Juan, Arroyo Kevin, Jaramillo Katherine, Lluglla Ligia, Gutierrez Bernardo, Gálvez Patricio

机构信息

PGY4 Surgery Resident at Pontificia Universidad del Ecuador, Quito, Ecuador.

Head and Neck Surgery, Universidad Autónoma de México, Mexico.

出版信息

Int J Surg Case Rep. 2020;71:382-385. doi: 10.1016/j.ijscr.2020.03.032. Epub 2020 Apr 1.

Abstract

BACKGROUND

Mycotic pseudoaneurysm of the carotid artery is a severe and rare disease. When it ruptures, it can produce severe morbidity and high mortality. It presents clinically as a pulsatile mass, usually diagnosable by computed tomography angiography with definitive confirmation achieved by establishing the presence of the pathogen in the tissue sample.

CASE PRESENTATION

We present the case of a 68-year-old male patient with a history of total laryngectomy. He presented with painful and pulsatile mass in his neck and, after precise evaluation, a ruptured carotid mycotic pseudoaneurysm was promptly detected and treated. After a surgical intervention and an adequate course of antibiotics, the patient successfully recovered.

CONCLUSIONS

Mycotic pseudoaneurysms of the extracranial carotid artery are uncommon and should always be surgically treated. Due to the high risk of potential complications, restoration of the arterial flow should be attempted in all occasions. High clinical awareness is imperative when approaching a mycotic pseudoaneurysm due to its wide spectrum of clinical symptoms, and must always be considered when diagnosing tumors of the neck. Despite its rarity, early detection and prompt treatment are critical to minimize the possibility of a fatal outcome.

摘要

背景

颈动脉霉菌性假性动脉瘤是一种严重且罕见的疾病。破裂时,可导致严重的发病率和高死亡率。临床上表现为搏动性肿块,通常通过计算机断层血管造影诊断,通过在组织样本中确定病原体来明确确诊。

病例报告

我们报告一例68岁男性患者,有全喉切除术病史。他颈部出现疼痛性搏动性肿块,经过精确评估,迅速检测并治疗了破裂的颈动脉霉菌性假性动脉瘤。经过手术干预和适当疗程的抗生素治疗后,患者成功康复。

结论

颅外颈动脉霉菌性假性动脉瘤并不常见,应始终进行手术治疗。由于潜在并发症风险高,应在所有情况下尝试恢复动脉血流。由于霉菌性假性动脉瘤临床症状范围广泛,因此在处理时必须具备高度的临床意识,在诊断颈部肿瘤时也必须始终考虑到这一点。尽管罕见,但早期发现和及时治疗对于将致命后果的可能性降至最低至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3769/7322741/597c28cf0f10/gr1.jpg

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