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腹主动脉结核性动脉瘤破裂:两个病例系列

Ruptured tuberculous aneurysms of the abdominal aorta: Two case series.

作者信息

Tran Hung Vinh, Ho Duc Khanh, Le Van Hoang, Van Duong Hai

机构信息

Director of Binh Dan Hospital HCMC, Viet Nam; Head of General Surgery Department, Pham Ngoc Thach University of Medicine, Viet Nam.

Chief of Heart and Vessels Surgical Ward, Binh Dan Hospital HCMC, Viet Nam.

出版信息

Int J Surg Case Rep. 2022 Mar;92:106860. doi: 10.1016/j.ijscr.2022.106860. Epub 2022 Feb 25.

Abstract

BACKGROUND

Ruptured aneurysms secondary to the tuberculous infection of the aorta are a rare and life-threatening disease. We report a single-center experience of two patients with ruptured infrarenal tuberculous aneurysms.

CASE PRESENTATION

We report 2 patients with ruptures of the tuberculous aneurysm. All patients had acute abdominal pain and were diagnosed by echography then CT scan preoperatively. The first patient (male, 50 years old) had a ruptured saccular aneurysm. The second patient (male, 43 years old) had a retroperitoneal contained rupture. All were treated by open prosthetic repair, by vascular surgeons. The two patients were well after operations. The diagnosis was confirmed by pathology examination. Antituberculous treatment was introduced after the operation.

CONCLUSIONS

Ruptured tuberculous aneurysms are rare but life-threatening. The diagnosis requires a high degree of suspicion. The treatment includes early diagnosis and emergent surgical intervention, extensive excision of infected field, aortic reconstruction, and prolonged antituberculous drug therapy.

摘要

背景

继发于主动脉结核感染的破裂性动脉瘤是一种罕见且危及生命的疾病。我们报告了单中心2例肾下型结核性动脉瘤破裂患者的治疗经验。

病例报告

我们报告了2例结核性动脉瘤破裂患者。所有患者均有急性腹痛,术前经超声检查后行CT扫描确诊。首例患者(男性,50岁)为囊状动脉瘤破裂。第二例患者(男性,43岁)为腹膜后局限性破裂。所有患者均由血管外科医生行开放性人工血管修复术治疗。术后2例患者情况良好。病理检查确诊。术后开始抗结核治疗。

结论

破裂性结核性动脉瘤虽罕见但危及生命。诊断需要高度怀疑。治疗包括早期诊断和紧急手术干预、广泛切除感染灶、主动脉重建以及延长抗结核药物治疗时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b10/8886133/02d68bf1d509/gr1.jpg

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