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主动脉肠瘘导致的致命性出血:一例报告

Fatal Hemorrhage Due to Aorto-Enteric Fistula: A Case Report.

作者信息

Alaithan Tajah M, Alaithan Abdullah M, Alnasser Lujain M, Alnakhli Ali A, Alharbi Ahlam

机构信息

General Practice, Almaarefa University, Riyadh, SAU.

General Practice, Al-Omran General Hospital, Al-Ahsa, SAU.

出版信息

Cureus. 2023 Apr 15;15(4):e37620. doi: 10.7759/cureus.37620. eCollection 2023 Apr.

Abstract

The abdominal aortic aneurysm (AAA) is a vascular condition that commonly affects individuals over the age of 65, leading to complications such as rupture, thrombosis, and embolization that can result in significant morbidity and mortality. Aorto-enteric fistula (AEF), a rare but life-threatening complication of abdominal aortic aneurysms, occurs when there is communication between the aneurysm and adjacent bowel loops. A 63-year-old man presented to the emergency department (ED) with severe abdominal pain, nausea, vomiting, and dark, tarry stools. Prior to his current presentation, the patient sought medical care from several primary care centers for vague abdominal pain that was diagnosed as dyspepsia, and he was prescribed omeprazole. During the current presentation, the patient had hemodynamic instability and a diffusely tender abdomen. Subsequently, a computed tomography (CT) scan revealed an abdominal aortic aneurysm with AEF. Although the patient underwent exploratory laparotomy, he suffered cardiac arrest and ultimately died in the operating room. This case underscores the importance of early recognition and management of AEF, which is crucial for improving patient outcomes.

摘要

腹主动脉瘤(AAA)是一种血管疾病,通常影响65岁以上的个体,可导致破裂、血栓形成和栓塞等并发症,进而引发严重的发病率和死亡率。主动脉肠瘘(AEF)是腹主动脉瘤一种罕见但危及生命的并发症,当动脉瘤与相邻肠袢之间存在连通时就会发生。一名63岁男性因严重腹痛、恶心、呕吐及黑便来到急诊科就诊。在此次就诊之前,该患者曾因不明原因的腹痛前往多个初级保健中心就医,被诊断为消化不良,并开具了奥美拉唑。在此次就诊期间,患者出现血流动力学不稳定及全腹压痛。随后,计算机断层扫描(CT)显示腹主动脉瘤合并AEF。尽管患者接受了剖腹探查术,但仍发生心脏骤停,最终在手术室死亡。该病例强调了早期识别和处理AEF的重要性,这对于改善患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd6a/10185296/3cde88a4d6b9/cureus-0015-00000037620-i01.jpg

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