一名4岁男性尺动脉假性动脉瘤的诊断与处理
Diagnosis and Management of a 4-Year-Old Male with Ulnar Artery Pseudoaneurysm.
作者信息
Artz Nicolas, Scwartzberg Harel, Yoo Aran, Cable Matthew, Tuggle Charles
机构信息
Department of Orthopaedic Surgery, Louisiana State University Health Science Center, New Orleans, Louisiana.
出版信息
Eplasty. 2023 Nov 13;23:e69. eCollection 2023.
BACKGROUND
Pseudoaneurysms are a rare vascular phenomenon caused by an intimal tear leading to hemorrhaging into surrounding tissue. Upper extremity pseudoaneurysms are well documented in adult patients and are attributed to repetitive trauma. Pediatric pseudoaneurysms are rare and are frequently misdiagnosed, which could lead to serious complications.
METHODS
This report presents the case of a 4-year-old male patient with an ulnar pseudoaneurysm of the right upper extremity. The pseudoaneurysm was diagnosed by ultrasound and computed tomography angiography and subsequently resected. The ulnar artery was reconstructed with an arterial graft using the descending branch of the lateral circumflex femoral artery. Patency of the end-to-end anastomosis was confirmed by strip testing and Allen's test.
CONCLUSIONS
The aim of this report is to provide a background of upper extremity pseudoaneurysms and describe their rare occurrence in pediatric patients and potential for complications upon misdiagnosis. Additionally, this report aims to highlight an alternative approach to management of pediatric pseudoaneurysms and advocate for reconstruction of the affected artery regardless of collateral flow being established.
背景
假性动脉瘤是一种罕见的血管现象，由内膜撕裂导致血液渗入周围组织引起。成人上肢假性动脉瘤已有充分记录，且归因于重复性创伤。小儿假性动脉瘤罕见，常被误诊，这可能导致严重并发症。
方法
本报告介绍了一名4岁男性患者，其右上肢尺侧出现假性动脉瘤。通过超声和计算机断层血管造影诊断出假性动脉瘤，随后进行了切除。使用旋股外侧动脉降支的动脉移植物重建尺动脉。通过剥脱试验和艾伦试验确认了端端吻合的通畅性。
结论
本报告的目的是提供上肢假性动脉瘤的背景信息，描述其在小儿患者中的罕见情况以及误诊后发生并发症的可能性。此外，本报告旨在强调小儿假性动脉瘤的另一种治疗方法，并主张无论是否已建立侧支循环，都应对受影响的动脉进行重建。
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