Johnson W C, Gale M E, Gerzof S G, Robbin A H, Nabseth D C
Surg Gynecol Obstet. 1986 Jan;162(1):49-53.
Forty-seven patients with an abdominal aortic aneurysm (AAA) and recent onset of abdominal or back pain were evaluated by emergency computed tomography (CT) to identify those patients with a confined rupture, and unstable aneurysm, nonaneurysmal cause of pain and a stable AAA. CT suggested that 25 per cent of these had a confined rupture and should undergo emergency surgical treatment. Rupture was confirmed at operation in one-half of these instances. Thirteen per cent avoided operation since other significant pathologic factors were identified. The remaining 47 per cent benefited from optimal preoperative evaluation and semielective surgical treatment. No patient ruptured an AAA during the delay for complete preoperative evaluation and preparation. Additionally, a preoperative CT is useful to identify patients with an unsuspected iliac, suprarenal, thoracic or inflammatory aneurysm. Thus, we believe that CT has a particularly important role in the evaluation of the symptomatic AAA, adding it to the list of indications for CT evaluation of difficult aortic disorders.
对47例患有腹主动脉瘤（AAA）且近期出现腹痛或背痛的患者进行了急诊计算机断层扫描（CT）评估，以确定那些存在局限性破裂、不稳定动脉瘤、非动脉瘤性疼痛原因以及稳定AAA的患者。CT显示，其中25%的患者存在局限性破裂，应接受急诊手术治疗。这些病例中有一半在手术中证实发生了破裂。13%的患者因发现其他重要病理因素而避免了手术。其余47%的患者受益于最佳的术前评估和半选择性手术治疗。在进行完整术前评估和准备的延迟期间，没有患者发生AAA破裂。此外，术前CT有助于识别未被怀疑的髂动脉、肾上腺、胸主动脉或炎性动脉瘤患者。因此，我们认为CT在有症状AAA的评估中具有特别重要的作用，应将其列入对疑难主动脉疾病进行CT评估的适应证清单。
