Huang Derrick, Huttleston Alexander, Fraunfelter Frank, Leon Leoh N, Ganti Latha
Emergency Medicine, HCA Florida Ocala Hospital, Ocala, USA.
Emergency Medicine, University of Central Florida College of Medicine, Ocala, USA.
Cureus. 2022 Jul 31;14(7):e27536. doi: 10.7759/cureus.27536. eCollection 2022 Jul.
Penetrating aortic ulcer (PAU) complicated by an intramural hematoma is a rare and potentially life-threatening emergency department (ED) presentation that is defined by progressive ulceration through the intima layer into the media layer of the aorta. Symptomatic PAUs can be clinically indistinguishable from other life-threatening pathologies such as aortic dissection, acute coronary syndrome (ACS), intrabdominal catastrophes as well as less lethal processes such as musculoskeletal back pain. Given the potential of PAUs to result in lethal aortic rupture and dissection, the emergency provider should maintain a high index of suspicion in patients with risk factors for aortic pathologies and utilize diagnostic modalities such as point-of-care ultrasound (POCUS) to expedite diagnosis.
穿透性主动脉溃疡（PAU）合并壁内血肿是一种罕见且可能危及生命的急诊科（ED）表现，其定义为内膜层溃疡进展至主动脉中膜层。有症状的PAU在临床上可能与其他危及生命的疾病难以区分，如主动脉夹层、急性冠状动脉综合征（ACS）、腹腔内灾难，以及与肌肉骨骼背痛等致死性较低的疾病。鉴于PAU有导致致命性主动脉破裂和夹层的可能性，急诊医生应对有主动脉疾病危险因素的患者保持高度怀疑，并利用即时超声（POCUS）等诊断手段加快诊断。
