Lonzanida Jaymes A J, Love Bryan E, Anderson Brian L
Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California.
Desert Regional Medical Center, Desert Trauma Surgeons, Palm Springs, California.
Clin Pract Cases Emerg Med. 2023 Feb;7(1):33-35. doi: 10.5811/cpcem.2022.10.57671.
Popliteal artery aneurysms are in most cases asymptomatic but cause significant complications if ruptured. An acute popliteal aneurysm rupture is relatively rare, and few cases have been documented secondary to blunt trauma. Common presenting signs and symptoms include distal limb ischemia and absent dorsalis pedis pulses. Timely management and recognition of this rare presentation are crucial as this condition can result in limb loss or death if not treated in a timely manner.
An 80-year-old man with history of hypertension presented to the emergency department complaining of inability to feel sensation below his left knee after falling from ground level. Physical examination was pertinent for bounding radial and femoral pulses bilaterally, although absent dorsalis pedis and posterior tibial pulses to the left lower extremity. Computed tomography angiography identified occlusion of the left superficial femoral arterial lumen associated with a ruptured popliteal aneurysm, approximately eight centimeters in size. He immediately received unfractionated heparin and was admitted to the hospital for left medial thigh exploration and decompressive dermatofasciotomy.
After confirmation of popliteal aneurysmal rupture with advanced imaging, heparinization and vascular surgery consultation are critical steps that should be taken to prevent limb loss.
腘动脉瘤在大多数情况下无症状，但破裂时会引发严重并发症。急性腘动脉瘤破裂相对罕见，继发于钝性创伤的病例记录较少。常见的症状和体征包括肢体远端缺血和足背动脉搏动消失。及时处理和识别这种罕见表现至关重要，因为如果不及时治疗，这种情况可能导致肢体丧失或死亡。
一名80岁有高血压病史的男性因从地面摔倒后左膝以下感觉丧失而就诊于急诊科。体格检查发现双侧桡动脉和股动脉搏动有力，但左下肢足背动脉和胫后动脉搏动消失。计算机断层血管造影显示左股浅动脉管腔闭塞，伴有一个大小约为8厘米的破裂腘动脉瘤。他立即接受了普通肝素治疗，并被收入院进行左大腿内侧探查和减压性筋膜切开术。
在通过先进影像学确诊腘动脉瘤破裂后，肝素化和血管外科会诊是预防肢体丧失应采取的关键步骤。
