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一例罕见的经手术治疗的巨大真性主肺动脉瘤:病例报告。

A rare case of large true main pulmonary artery aneurysm managed surgically: A case report.

作者信息

Sohail Abdul Ahad, Madni Varisha, Wahab Rida, Ahmad Waris, Inam Hina

机构信息

Cardio-thoracic Surgery, Aga Khan University Hospital Karachi, Pakistan.

Aga Khan University Hospital, Pakistan.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110072. doi: 10.1016/j.ijscr.2024.110072. Epub 2024 Jul 26.

Abstract

INTRODUCTION & IMPORTANCE: Pulmonary Artery Aneurysm is defined as the localized dilation of the pulmonary artery >1.5 times the upper normal limit or pulmonary artery measuring 4 cm. Pulmonary artery aneurysm is considered as a rare disorder having an incidence of 1 in 14,000 post-mortem examinations.

CASE PRESENTATION

Presented below is a case of a 28 year old gentleman, who presented with exertional dyspnea and orthopnea and was diagnosed with having a pulmonary artery aneurysm of 76 cm × 56 cm × 53 cm arising from the main pulmonary artery upon Computed Tomography Scan which is a rare finding according to the available literature.

CLINICAL DISCUSSION

Clinical manifestations of pulmonary artery aneurysm are varying and rarely occur. However the use of radiological imaging has aided in the diagnosis. No specific treatment guidelines have been mentioned yet in the literature however, medical management, surgical resection and endovascular therapy are one of the multiple options available.

CONCLUSION

Pulmonary Artery Aneurysm presents with non-specific symptoms which makes the diagnosis very challenging for the physicians, in process, delaying the accurate management of the disease. However, pulmonary artery aneurysm must be considered as a differential diagnosis and appropriate management options, whether medical or surgical should be opted for keeping in mind the size and the complications of the disease.

摘要

引言与重要性

肺动脉瘤被定义为肺动脉的局限性扩张,其直径大于正常上限的1.5倍或肺动脉直径达到4厘米。肺动脉瘤被认为是一种罕见疾病,在尸检中的发病率为1/14000。

病例介绍

以下介绍一名28岁男性病例,该患者出现劳力性呼吸困难和端坐呼吸,经计算机断层扫描诊断为源于主肺动脉的肺动脉瘤,大小为76厘米×56厘米×53厘米,这是现有文献中罕见的发现。

临床讨论

肺动脉瘤的临床表现多样且罕见。然而,放射影像学检查有助于诊断。文献中尚未提及具体的治疗指南,不过,药物治疗、手术切除和血管内治疗是可用的多种选择之一。

结论

肺动脉瘤表现为非特异性症状,这给医生的诊断带来很大挑战,进而延误了疾病的准确治疗。然而,必须将肺动脉瘤视为鉴别诊断的考虑因素,并根据疾病的大小和并发症,选择合适的治疗方案,无论是药物治疗还是手术治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50d5/11372862/12e0a18bf64c/gr1.jpg

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