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双侧髂总动脉瘤的偶然诊断:一例报告及文献综述

Incidental diagnosis of bilateral common iliac artery aneurysms: a case report and comprehensive literature review.

作者信息

Katwal Shailendra, Katwal Srijana, Bhandari Sushmita, Paudel Pratiksha, Bhandari Devendra, Bhandari Shristi, Maharjan Santosh

机构信息

Department of Radiology, Dadeldhura Subregional Hospital, Dadeldhura.

Department of Cardiology, National Academy of Medical Science.

出版信息

Ann Med Surg (Lond). 2024 Jul 17;86(9):5545-5550. doi: 10.1097/MS9.0000000000002382. eCollection 2024 Sep.

Abstract

INTRODUCTION AND IMPORTANCE

Aneurysms are dilatations of arteries, with abdominal aortic ectasias (AAE) considered precursors to abdominal aortic aneurysms (AAA). Iliac artery aneurysms (IAAs), often accompanying AAA, present a serious risk, particularly due to rupture. Here, the authors present a case highlighting the importance of recognizing and managing isolated bilateral common iliac artery aneurysms (CIAAs).

CASE PRESENTATION

A 66-year-old male presented following a road traffic accident (RTA) with ankle and leg pain. Examination revealed tenderness in the leg, mild right flank tenderness, and a history of mild pelvic pain. Biochemical studies showed deranged glucose and lipid levels. Imaging revealed large CIAAs, prompting surgical intervention. The patient's fracture was also managed accordingly.

CLINICAL DISCUSSION

CIAAs are rare but serious, typically occurring in elderly males with risk factors including advanced age, male sex, smoking, and hypertension, while diabetes and hyperlipidemia may exert protective effects. While often asymptomatic, they can lead to complications such as thrombosis or rupture. Diagnosis relies on imaging, and intervention is recommended for larger or symptomatic aneurysms.

CONCLUSION

It's crucial to consider CIAAs in high-risk individuals and recognize the significance of early detection and intervention to prevent potentially life-threatening complications. Prompt management, either through open surgical repair or endovascular options, is crucial for improving patient outcomes.

摘要

引言与重要性

动脉瘤是动脉的扩张,腹主动脉扩张(AAE)被认为是腹主动脉瘤(AAA)的先兆。髂动脉瘤(IAA)常与AAA并存,存在严重风险,尤其是破裂风险。在此,作者报告一例病例,强调认识和处理孤立性双侧髂总动脉瘤(CIAAs)的重要性。

病例介绍

一名66岁男性在道路交通事故(RTA)后出现踝关节和腿部疼痛。检查发现腿部压痛、右侧腰部轻度压痛,并有轻度盆腔疼痛病史。生化检查显示血糖和血脂水平异常。影像学检查发现巨大的CIAAs,促使进行手术干预。患者的骨折也得到了相应处理。

临床讨论

CIAAs罕见但严重,通常发生在有危险因素的老年男性中,这些危险因素包括高龄、男性、吸烟和高血压,而糖尿病和高脂血症可能具有保护作用。虽然通常无症状,但可导致血栓形成或破裂等并发症。诊断依赖于影像学检查,对于较大或有症状的动脉瘤建议进行干预。

结论

在高危个体中考虑CIAAs并认识到早期检测和干预对于预防潜在危及生命的并发症的重要性至关重要。通过开放手术修复或血管内治疗等及时处理对于改善患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0736/11374284/ec763ef4bebd/ms9-86-5545-g001.jpg

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