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以急诊床边超声诊断肾动脉动脉瘤:病例报告并文献复习。

Diagnosis of Renal Artery Aneurysm by Point-of-Care Ultrasound in the Emergency Department: A Case Report and Brief Review of the Literature.

机构信息

Department of Emergency Medicine, Penn Presbyterian Medical Center, Philadelphia.

Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

出版信息

J Emerg Med. 2022 Aug;63(2):e57-e59. doi: 10.1016/j.jemermed.2022.05.015. Epub 2022 Aug 11.

Abstract

BACKGROUND

Renal artery aneurysm (RAA) is defined as a focal dilatation of ≥50% of the adjacent, disease-free artery. Although typically asymptomatic, RAA can lead to hypertension, hematuria, and rupture. The risk of rupture is higher in pregnant patients and may result in the death of the mother and the fetus. We describe a case of RAA discovered on point-of-care ultrasound (POCUS) in the emergency department.

CASE REPORT

A 46-year-old woman with no medical history presented to the emergency department with lower abdominal pain, vomiting, diarrhea, and increased urination. POCUS was performed to evaluate the cause of the patient's symptoms. This study revealed a 2.40 cm × 3.65 cm aneurysm in the right kidney. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Rupture of RAA occurs in 3% to 5% of cases. Mortality to both the mother and the fetus is particularly high in gravid patients. RAA may be mistaken for other renal entities such as prominent renal veins or hydronephrosis. Properly identifying this pathology via POCUS can lead to early intervention. © 2022 Elsevier Inc.

摘要

背景

肾动脉动脉瘤(RAA)定义为≥相邻无病变动脉 50%的局部扩张。尽管通常无症状,但 RAA 可导致高血压、血尿和破裂。妊娠患者破裂风险较高,可能导致母亲和胎儿死亡。我们描述了在急诊科即时护理超声(POCUS)中发现的 RAA 病例。

病例报告

一名 46 岁无病史的女性因下腹痛、呕吐、腹泻和排尿增多就诊于急诊科。进行 POCUS 以评估患者症状的原因。该研究显示右肾有一个 2.40 厘米×3.65 厘米的动脉瘤。

为什么急诊医生应该注意这一点?RAA 的破裂在 3%至 5%的病例中发生。在妊娠患者中,母亲和胎儿的死亡率特别高。RAA 可能与其他肾脏实体混淆,如突出的肾静脉或肾积水。通过 POCUS 正确识别这种病理可以进行早期干预。©2022 Elsevier Inc.

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