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一名19岁男性患者脾动脉动脉瘤自发性破裂致急腹症:病例报告

Spontaneous rupture of a splenic artery aneurysm causing acute abdomen in a 19-year-old male patient: a case report.

作者信息

Njoum Yumna, Barqawi Abdallah Deghles, Maree Mohammed

机构信息

Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.

Department of Surgery, Al-Makassed Hospital, Jerusalem, Palestine.

出版信息

Front Surg. 2023 Sep 18;10:1223271. doi: 10.3389/fsurg.2023.1223271. eCollection 2023.

Abstract

INTRODUCTION

A splenic artery aneurysm is considered an abnormal dilatation of the splenic artery layers greater than 1 cm in diameter. First described by Beaussier in 1770, it affects 1% of the population but carries a major risk for life-threatening complications of rupture in 3%-10% of cases regardless of its congenital or acquired etiology. The presentation is highly variable, from asymptomatic incidental discovery during routine imaging to aneurysmal rupture causing acute abdomen, massive gastrointestinal bleeding, and hemorrhagic shock.

CASE PRESENTATION

Herein, we present a 19-year-old male patient who presented with epigastric pain and abdominal rigidity associated with a moderate amount of free peritoneal fluid that was found to be a ruptured SAA after immediate laparoscopy, which was successfully managed with splenectomy.

CONCLUSION

SAAs are a rare etiology of acute abdomen and hemorrhagic shock but have a very high risk of mortality even upon immediate intervention, requiring a very high level of vigilance and a low threshold for surgical intervention in unstable patients presenting with abdominal pain.

摘要

引言

脾动脉瘤被认为是脾动脉各层直径大于1厘米的异常扩张。1770年由博西耶首次描述,它影响1%的人群,但无论其先天性或后天性病因如何,在3%-10%的病例中都有发生危及生命的破裂并发症的重大风险。其表现高度多变,从常规影像学检查时无症状的偶然发现到动脉瘤破裂导致急腹症、大量胃肠道出血和失血性休克。

病例介绍

在此,我们报告一名19岁男性患者,他因上腹部疼痛和腹部强直就诊,伴有中等量的游离腹腔积液,急诊腹腔镜检查发现是破裂的脾动脉瘤,经脾切除术成功治疗。

结论

脾动脉瘤是急腹症和失血性休克的罕见病因,但即使立即干预,死亡率也非常高,对于出现腹痛的不稳定患者,需要高度警惕并降低手术干预的阈值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7532/10544323/607bef433241/fsurg-10-1223271-g001.jpg

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