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一名年轻女性的自发性孤立性腹腔干夹层

Spontaneous Isolated Celiac Artery Dissection in a Young Woman.

作者信息

Tanabe Mao, Urushidani Seigo

机构信息

Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, JPN.

出版信息

Cureus. 2024 Oct 15;16(10):e71539. doi: 10.7759/cureus.71539. eCollection 2024 Oct.

Abstract

Spontaneous isolated celiac artery dissection (SICAD) is a rare phenomenon with an unclear pathogenesis. It is more common in men, with a predilection for those in their 50s. A 39-year-old woman with epigastric and back pain visited our emergency department (ED). She had no cardiovascular risk factors. On her first visit to the ED, no signs of peritonitis were noted, and her vital signs were normal. Although a non-contrast abdominal computed tomography (CT) scan was performed, the cause of her abdominal pain remained unidentified. Due to persistent mild-to-severe pain, the patient visited our ED again the following day. Despite repeated blood tests showing no abnormalities, we considered that her abdominal pain was of vascular origin. We performed a contrast-enhanced CT scan, which revealed poor contrast enhancement in the celiac artery without intestinal ischemia. Based on the medical history and CT findings, the patient was diagnosed with SICAD. We consulted a cardiovascular surgeon who advised conservative management. The patient was discharged on the 10th day after admission, and no recurrence of abdominal pain was reported. SICAD is a rare but potentially serious condition that can also occur in younger women. While certain risk factors for SICAD have been identified, some young patients may not have traditional risk factors. Physicians should consider SICAD as a differential diagnosis even in young women when their abdominal pain is persistent without other organ-specific signs.

摘要

自发性孤立性腹腔干动脉夹层(SICAD)是一种发病机制不明的罕见现象。它在男性中更为常见,好发于50多岁的人群。一名39岁的上腹部和背部疼痛的女性前来我们的急诊科就诊。她没有心血管危险因素。在她首次就诊于急诊科时,未发现腹膜炎体征,生命体征正常。尽管进行了非增强腹部计算机断层扫描(CT),但她腹痛的原因仍未明确。由于疼痛持续存在且程度从轻度到重度不等,患者第二天再次前来我们的急诊科。尽管多次血液检查显示无异常,但我们认为她的腹痛源于血管。我们进行了增强CT扫描,结果显示腹腔干动脉造影剂增强不佳,但无肠缺血表现。根据病史和CT检查结果,该患者被诊断为SICAD。我们咨询了心血管外科医生,医生建议采取保守治疗。患者在入院后第10天出院,未报告腹痛复发。SICAD是一种罕见但可能严重的疾病,也可发生于年轻女性。虽然已确定了SICAD的某些危险因素,但一些年轻患者可能没有传统的危险因素。当年轻女性持续性腹痛且无其他器官特异性体征时,医生即使在这些患者中也应将SICAD作为鉴别诊断之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef4f/11563760/efd83ee9b003/cureus-0016-00000071539-i01.jpg

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