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咯血作为胸主动脉假性动脉瘤的警示信号:一例报告。

Hemoptysis as a warning sign of thoracic aorta pseudoaneurysm: A case report.

机构信息

Centro de Excelencia para Manejo de Tuberculosis Luz Caviedes Rojas-Hospital Regional Docente de Trujillo, Trujillo, Perú; Departamento de Medicina, Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Perú. Adress: Manzana A Lote 1-M, Urbanización Los Portales del Golf, Víctor Larco Trujillo, Perú. Email:

Centro de Excelencia para Manejo de Tuberculosis Luz Caviedes Rojas-Hospital Regional Docente de Trujillo, Trujillo, Perú; Departamento de Medicina, Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Perú. ORCID: 0000-0003-0462-3101.

出版信息

Medwave. 2021 Feb 9;21(1):e8112. doi: 10.5867/medwave.2021.01.8112.

Abstract

Pseudoaneurysm is defined as a reperfused pulsatile hematoma, encapsulated and communicated with the damaged vessel's lumen. It originates when there is a disruption of the arterial wall. Hemoptysis is a very rare sign/symptom of a thoracic aortic aneurysm or pseudoaneurysm. There is little information on hemoptysis associated with aortic aneurysm rupture, whose mechanisms are not explained by the presence of an aortopulmonary fistula. Among the hypotheses to explain this phenomenon, is the ability of the bronchial arteries to become hyperplasic and tortuous in the presence of a lesion that modifies the pulmonary architecture, being more susceptible to rupture. There are also descriptions of direct lung parenchymal injury from ruptured aneurysm. The present case illustrates that we must consider the hemoptysis as a warning sign in differential diagnosis of aortic aneurysms and pseudo aneurysms, among other causes, that it can be fatal in a short time due to massive hemorrhage.

摘要

假性动脉瘤定义为再灌注的搏动性血肿,被囊包裹并与受损血管腔相通。它起源于动脉壁破裂。咳血是胸主动脉瘤或假性动脉瘤的非常罕见的症状/体征。关于与主动脉瘤破裂相关的咳血,信息很少,其机制不能用主-肺动脉瘘的存在来解释。在解释这种现象的假说中,是在改变肺结构的病变存在下,支气管动脉能够变得增生和扭曲,更容易破裂。也有描述直接的肺实质损伤来自破裂的动脉瘤。本病例说明,我们必须将咳血视为主动脉瘤和假性动脉瘤等其他病因鉴别诊断中的警告信号,由于大量出血,它可能在短时间内致命。

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