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伴有感染性腹膜后血肿的肾下腹主动脉复杂性霉菌性囊状动脉瘤：1例临床病例报告

Complicated mycotic saccular aneurysm of the infra-renal abdominal aorta with infected retroperitoneal hematoma: a clinical case report.

作者信息

Chinaliyev A M, Jussubaliyev Y I, Khassenov D T, Sabyruly D, Shaimerden E M, Kapyshev M S, Aleushinov R I, Aitkul S Sh, Yessenbayeva G A, Sagandykov I N, Sultanaliyev T A

机构信息

National Research Oncology Center, Astana, Kazakhstan.

出版信息

Front Cardiovasc Med. 2024 Nov 21;11:1497561. doi: 10.3389/fcvm.2024.1497561. eCollection 2024.

DOI:10.3389/fcvm.2024.1497561
PMID:39639977
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11617553/
Abstract

BACKGROUND

Rupture of an abdominal aortic aneurysm (AAA) is a life-threatening emergency, with untreated cases nearing a 100% mortality rate. This case presents a rare complication of AAA rupture with an infected retroperitoneal hematoma, emphasizing the importance of timely diagnosis and a multidisciplinary approach.

CASE PRESENTATION

A 59-year-old male presented with lower back pain, fever, and difficulty moving, persisting for three weeks. Imaging revealed a saccular infra-renal AAA rupture with an infected retroperitoneal hematoma. Emergency surgery included extracorporeal subclavian-femoral bypass and aneurysm resection. Despite intraoperative complications, the patient recovered after 16 days in intensive care and was discharged in satisfactory condition. Follow-up CT one month later showed functioning bypasses and clinical improvement.

CONCLUSION

This case illustrates the critical need for early diagnosis and coordinated surgical intervention in complex AAA ruptures complicated by infection. Timely multidisciplinary treatment is crucial to prevent further complications and improve patient outcomes.

摘要

背景

腹主动脉瘤（AAA）破裂是一种危及生命的紧急情况，未经治疗的病例死亡率接近100%。本病例呈现了AAA破裂伴感染性腹膜后血肿这一罕见并发症，强调了及时诊断和多学科方法的重要性。

病例介绍

一名59岁男性出现下背部疼痛、发热和活动困难，持续三周。影像学检查显示肾下囊状AAA破裂伴感染性腹膜后血肿。急诊手术包括体外锁骨下-股动脉旁路移植术和动脉瘤切除术。尽管术中出现并发症，但患者在重症监护室治疗16天后康复，出院时情况良好。一个月后的随访CT显示旁路移植血管功能良好，临床症状改善。

结论

本病例表明，对于复杂的伴有感染的AAA破裂，早期诊断和协调的手术干预至关重要。及时的多学科治疗对于预防进一步并发症和改善患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/2596e3a7756f/fcvm-11-1497561-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/f1b7348b3036/fcvm-11-1497561-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/cdc435ac250b/fcvm-11-1497561-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/a1f397b2099e/fcvm-11-1497561-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/d463dacce418/fcvm-11-1497561-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/2596e3a7756f/fcvm-11-1497561-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/f1b7348b3036/fcvm-11-1497561-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/cdc435ac250b/fcvm-11-1497561-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/a1f397b2099e/fcvm-11-1497561-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/d463dacce418/fcvm-11-1497561-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b5/11617553/2596e3a7756f/fcvm-11-1497561-g005.jpg

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Comparative clinical effectiveness and cost effectiveness of endovascular strategy open repair for ruptured abdominal aortic aneurysm: three year results of the IMPROVE randomised trial.血管内策略与开放修复治疗破裂腹主动脉瘤的比较临床疗效及成本效益：IMPROVE随机试验的三年结果
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