Walsh T J, Zachary J B, Hutchins G M, Sterioff S
Johns Hopkins Med J. 1977 Aug;141(2):85-90.
A hypertensive 37-year-old man underwent renal transplantation. The transplanted kidney was removed 5 days later, 21 months before his death. He was maintained after transplantation by hemodialysis. His postoperative course was complicated by recurrent pseudomonal infection with bacteremia. He presented with symptoms of acute peritoneal irritation and hypovolemia followed by sudden death. Postmortem examination revealed that a saccular mycotic aneurysm of the left common iliac artery, which was the site of post-transplant nephrectomy, had ruptured into the peritoneal cavity. The case exemplifies postoperative mycotic aneurysm, the frequently obscure clinical findings of iliac artery aneurysms, and the need for a high index of suspicion of mycotic aneurysm in patients undergoing renal transplantation.
一名37岁的高血压男性接受了肾移植手术。移植的肾脏在术后5天被切除，此时距离他去世还有21个月。移植后他通过血液透析维持生命。他的术后病程因反复出现假单胞菌感染伴菌血症而复杂化。他出现了急性腹膜刺激症状和血容量不足，随后突然死亡。尸检发现，左髂总动脉的一个囊状霉菌性动脉瘤破裂进入腹腔，该部位正是移植肾切除术后的位置。该病例体现了术后霉菌性动脉瘤、髂动脉动脉瘤常见的隐匿临床症状，以及肾移植患者对霉菌性动脉瘤高度怀疑的必要性。
