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活动性肺结核中的拉斯穆森动脉瘤:一例报告

Rasmussen's Aneurysm in Active Pulmonary Tuberculosis: A Case Report.

作者信息

Fadul Khalid Y, Alsayed Ahmed, Abdalla ELMustafa, Mohamed Rawan S, Salman Amjad M, Meer Ahmad, Fadul Abdalla

机构信息

Emergency Medicine, Hamad Medical Corporation, Doha, QAT.

Internal Medicine, Hamad Medical Corporation, Doha, QAT.

出版信息

Cureus. 2024 Aug 29;16(8):e68148. doi: 10.7759/cureus.68148. eCollection 2024 Aug.

Abstract

Hemoptysis is a common presenting symptom of pulmonary tuberculosis (TB). Rasmussen aneurysm can present with severe hemoptysis, which is usually diagnosed using computed tomography (CT) angiography. A false aneurysmal dilatation of the pulmonary artery is known as a Rasmussen aneurysm. It occurs due to a gradual weakening of the arterial wall adjacent to pulmonary cavitation. Computed tomography angiography of the chest is the standard diagnostic technique for Rasmussen aneurysm. An early angiographic or surgical procedure with vascular embolization is recommended following a definitive diagnosis. We present a 29-year-old woman whom the medical commission referred due to a cavitary lesion on a screening chest X-ray. Hospital admission was preferred for the infection workup, which revealed radiological evidence of the Rasmussen aneurysm. The patient was eventually treated as a case of active tuberculosis on a radiological basis via the decision of the local infectious disease (ID) team. The most common symptoms reported in patients with tuberculosis infection are hemoptysis, cough, low-grade fever, night sweats, and weight loss. Hemoptysis can rarely originate from the Rasmussen aneurysm of the pulmonary artery. However, hemoptysis is the predominant symptom in chronic cavitary tuberculosis with Rasmussen aneurysm. A CT pulmonary angiogram (CTPA) is considered the imaging modality of choice to confirm the diagnosis of Rasmussen aneurysm. Fatal hemoptysis is one of the consequences of a Rasmussen aneurysm if it is massive and not treated promptly. Confirming the diagnosis with proper follow-up is essential to preventing devastating outcomes.

摘要

咯血是肺结核(TB)常见的就诊症状。拉斯姆森动脉瘤可表现为严重咯血,通常采用计算机断层扫描(CT)血管造影进行诊断。肺动脉的假性动脉瘤样扩张被称为拉斯姆森动脉瘤。它是由于肺空洞附近动脉壁逐渐变薄而发生的。胸部CT血管造影是诊断拉斯姆森动脉瘤的标准技术。确诊后建议尽早进行血管造影或手术及血管栓塞治疗。我们报告一名29岁女性,因筛查胸部X线发现空洞性病变被医疗委员会转诊。因感染检查需要住院,检查发现了拉斯姆森动脉瘤的影像学证据。经当地传染病(ID)团队决定,最终根据影像学结果将该患者作为活动性肺结核病例进行治疗。肺结核感染患者最常见的症状是咯血、咳嗽、低热、盗汗和体重减轻。咯血很少起源于肺动脉的拉斯姆森动脉瘤。然而,咯血是伴有拉斯姆森动脉瘤的慢性空洞性肺结核的主要症状。CT肺动脉造影(CTPA)被认为是确诊拉斯姆森动脉瘤的首选影像学检查方法。如果拉斯姆森动脉瘤大量出血且未及时治疗,致命性咯血是其后果之一。通过适当的随访来确诊对于预防灾难性后果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5cb/11438579/bfe0318e4d25/cureus-0016-00000068148-i01.jpg

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