Higgins R, Peitzman A B, Reidy M, Stapczynski S, Steed D L, Webster M W
Department of Surgery, University of Pittsburgh School of Medicine, Pennyslvania 15261.
Ann Emerg Med. 1988 Mar;17(3):284-7. doi: 10.1016/s0196-0644(88)80125-2.
Rupture of an abdominal aortic aneurysm often presents with a pulsatile abdominal mass, abdominal pain, and hypotension. Recent clinical reports describe patients with less apparent clinical signs and symptoms who were found later in their evaluation to have a contained rupture of an abdominal aortic aneurysm. Even more unusual is a chronic contained rupture of an abdominal aortic aneurysm. Our patient had a chronic contained rupture of an abdominal aortic aneurysm that presented with erosion into the lumbar vertebral bodies and subsequent lumbar neuropathy. CT scan confirmed the contained rupture of the aortic aneurysm and the patient underwent successful repair of his aortic aneurysm. Our report discusses the significance of atypical presentations of abdominal aortic aneurysm rupture and the importance of prompt diagnosis and definitive repair.
腹主动脉瘤破裂常表现为搏动性腹部肿块、腹痛和低血压。近期临床报告描述了一些患者，其临床体征和症状不太明显，在评估后期才发现患有腹主动脉瘤局限性破裂。更不常见的是腹主动脉瘤慢性局限性破裂。我们的患者患有腹主动脉瘤慢性局限性破裂，表现为侵蚀腰椎椎体并继发腰神经病变。CT扫描证实了主动脉瘤的局限性破裂，患者接受了主动脉瘤的成功修复。我们的报告讨论了腹主动脉瘤破裂非典型表现的意义以及及时诊断和确定性修复的重要性。
