Bontinis Vangelis, Bontinis Alkis, Giannopoulos Argirios, Manaki Vasiliki, Kontes Ioannis, Ktenidis Kyriakos
Vascular Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Cureus. 2024 Feb 13;16(2):e54132. doi: 10.7759/cureus.54132. eCollection 2024 Feb.
Ulnar artery aneurysms (UAAs), although infrequent, pose limited challenges in terms of timely diagnosis and surgical intervention. Their intricacy lies in discerning and addressing the underlying pathology, often necessitating prolonged hospitalization. Herein, we present a case detailing a giant aneurysm located in the proximal ulnar artery, measuring 5.2 cm in diameter. The patient exhibited negative microbial cultures and non-pathological transthoracic echocardiography (TTE). Successful treatment involved aneurysmal exclusion and saphenous vein graft interposition. While the initial microbiological cultures and TTE yielded negative results, the diagnosis of endocarditis was ultimately confirmed through a subsequent transesophageal echocardiography (TEE) examination. This case report underscores the imperative for heightened clinical suspicion when confronted with upper-limb aneurysms. The diagnostic process necessitates sustained diligence for identifying the underlying pathology, a task that, in certain instances, requires prolonged hospitalization. Both microbiological cultures and TTE have exhibited diminished sensitivity in the diagnosis of infective endocarditis and should consistently be complemented by TEE.
尺动脉动脉瘤（UAA）虽不常见，但在及时诊断和手术干预方面面临的挑战有限。其复杂性在于识别和处理潜在病理情况，这通常需要长时间住院治疗。在此，我们报告一例详细病例，患者尺动脉近端有一个巨大动脉瘤，直径达5.2厘米。患者微生物培养结果为阴性，经胸超声心动图（TTE）检查无异常。成功的治疗方法是动脉瘤切除并置入大隐静脉移植血管。虽然最初的微生物培养和TTE结果均为阴性，但最终通过随后的经食管超声心动图（TEE）检查确诊为心内膜炎。本病例报告强调，面对上肢动脉瘤时，提高临床怀疑意识至关重要。诊断过程需要持续的努力以识别潜在病理情况，在某些情况下，这一任务需要长时间住院。微生物培养和TTE在感染性心内膜炎的诊断中敏感性均较低，应始终辅以TEE检查。
