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双侧肺动静脉畸形:罕见复杂病例中的挑战

Bilateral Pulmonary Arteriovenous Malformations: Challenges in a Rare and Complex Case.

作者信息

Joshi Aayushi, Saini Vasu, Bheemavarapu Bhumika, Cherukuri Anjani Mahesh Kumar, Shaban Mohd

机构信息

Pediatrics, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, IND.

Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IND.

出版信息

Cureus. 2024 Sep 26;16(9):e70231. doi: 10.7759/cureus.70231. eCollection 2024 Sep.

Abstract

Pulmonary arteriovenous malformations (PAVMs) are abnormal vascular connections between the pulmonary arteries and pulmonary veins. Despite their relatively uncommon incidence, PAVMs should be considered in the differential diagnosis of children presenting with cyanosis due to the life-threatening complications posed by paradoxical emboli. The primary management approach involves eliminating the abnormal connections, either through surgical or endovascular methods. We present a case of a five-year-old boy who was seen in the Outpatient Department with cyanosis of the lips and nail beds persisting for eight months. On examination, grade 3 clubbing was noted. Imaging and subsequent angiography revealed multiple bilateral diffuse AVMs, which were treated using an endovascular approach.

摘要

肺动静脉畸形(PAVM)是肺动脉和肺静脉之间的异常血管连接。尽管其发病率相对较低,但由于矛盾栓塞带来的危及生命的并发症,在对出现紫绀的儿童进行鉴别诊断时应考虑到PAVM。主要的治疗方法包括通过手术或血管内方法消除异常连接。我们报告一例5岁男孩的病例,该患儿在门诊就诊,嘴唇和甲床紫绀持续8个月。检查时发现有3级杵状指。影像学检查及随后的血管造影显示双侧多发弥漫性动静脉畸形,采用血管内方法进行了治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26bd/11512161/4f6b9cb45f9e/cureus-0016-00000070231-i01.jpg

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