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以双侧血胸为表现的胸主动脉夹层:一个潜在的漏诊。

Thoracic aortic dissection presenting with bilateral haemothoraces: a potentially missed diagnosis.

机构信息

South Australia Medical Imaging, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia

South Australia Medical Imaging, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.

出版信息

BMJ Case Rep. 2023 Aug 11;16(8):e254866. doi: 10.1136/bcr-2023-254866.

DOI:10.1136/bcr-2023-254866
PMID:37567738
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10423798/
Abstract

Thoracic aortic dissection is a life-threatening diagnosis, which should not be missed. We present a case in which a patient who presented to the emergency department with chest pain was assessed and referred for admission for treatment of pneumonia, due to misinterpretation of a chest radiograph finding. The patient was re-reviewed and subsequently underwent further investigation, which confirmed aortic dissection. She underwent emergency thoracic endovascular aortic graft repair with stent graft insertion. This case demonstrates haemothorax as an uncommon complication of aortic dissection.

摘要

胸主动脉夹层是一种危及生命的诊断,不应漏诊。我们报告了一例患者,该患者因胸痛就诊于急诊科,由于对胸部 X 线检查结果的错误解释,被评估并转至内科住院治疗肺炎。该患者再次被审查,随后进行了进一步的检查,证实为主动脉夹层。她接受了紧急胸主动脉腔内修复术,并置入支架移植物。本病例展示了血胸是主动脉夹层的一种罕见并发症。

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本文引用的文献

1
Thoracic endovascular aortic repair of a ruptured acute type B aortic dissection presenting with right hemothorax: a case report and review of the literature.胸腔镜血管内主动脉修复治疗以右侧血胸为表现的急性 B 型主动脉夹层破裂:病例报告及文献复习。
Gen Thorac Cardiovasc Surg. 2021 Oct;69(10):1438-1443. doi: 10.1007/s11748-021-01678-2. Epub 2021 Jun 30.
2
Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection.急性主动脉夹层的表现、诊断和结局:国际急性主动脉夹层注册研究 17 年趋势。
J Am Coll Cardiol. 2015 Jul 28;66(4):350-8. doi: 10.1016/j.jacc.2015.05.029.
3
[The clinical analysis of neurological symptoms in patients with aortic dissection].[主动脉夹层患者神经症状的临床分析]
Zhonghua Nei Ke Za Zhi. 2013 May;52(5):400-2.
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Ruptured acute type B aortic dissection presenting with bilateral hemathoraces.以双侧血胸为表现的急性B型主动脉夹层破裂。
J Card Surg. 2011 Mar;26(2):214-6. doi: 10.1111/j.1540-8191.2011.01209.x. Epub 2011 Feb 20.
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The diagnosis and management of aortic dissection.主动脉夹层的诊断与处理
Vasc Endovascular Surg. 2010 Apr;44(3):165-9. doi: 10.1177/1538574410362118.
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Acute aortic dissection: perspectives from the International Registry of Acute Aortic Dissection (IRAD).急性主动脉夹层:来自国际急性主动脉夹层注册研究(IRAD)的观点。
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Ruptured type B aortic dissection presenting with right hemothorax.以右侧血胸为表现的B型主动脉夹层破裂。
Diagn Interv Radiol. 2008 Mar;14(1):6-8.
8
Frequency of and inappropriate treatment of misdiagnosis of acute aortic dissection.急性主动脉夹层误诊的频率及不当治疗情况。
Am J Cardiol. 2007 Mar 15;99(6):852-6. doi: 10.1016/j.amjcard.2006.10.055. Epub 2007 Feb 2.
9
Chest radiography for the diagnosis of acute aortic syndrome.胸部X线摄影在急性主动脉综合征诊断中的应用
Am J Med. 2004 Jan 15;116(2):73-7. doi: 10.1016/j.amjmed.2003.08.030.
10
Clinical prediction of acute aortic dissection.急性主动脉夹层的临床预测
Arch Intern Med. 2000 Oct 23;160(19):2977-82. doi: 10.1001/archinte.160.19.2977.