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得益于实习医生进行的超声检查偶然发现腹主动脉瘤,并随后做出了两个“多米诺”诊断:病例报告及对超声课程作用的见解

Casual detection of an abdominal aortic aneurysm thanks to a trainee-made ultrasound with two subsequent "domino" diagnoses: case report and insights on the role of ultrasound courses.

作者信息

Oteri Vittorio, Galeano Francesco, Conti Andrea, Scavone Giovanni, Tumminia Andrea, Frasca Francesco, Romano Raffaella, Romano Marcello

机构信息

Endocrine Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Hospital, Catania, Italy.

Department of Diagnostic Radiology, Neuroradiology and Interventional Radiology, Garibaldi-Centro Hospital, Catania, Italy.

出版信息

J Ultrasound. 2024 Dec 21. doi: 10.1007/s40477-024-00979-5.

Abstract

Early detection of abdominal aortic aneurysm (AAA) is crucial as untreated lesions can be life-threatening. We describe the case of a fortuitous ultrasound (US) detection of AAA by a trainee which allowed two subsequent "domino" diagnoses. A 69 y.o. male underwent US to evaluate prostate and bladder. He was a heavy smoker affected by hypertension and dyslipidemia. An endocrinology resident and ultrasound trainee started the exam accidentally from the epigastrium and found a fusiform aneurysmal lesion. Subsequent computed tomography (CT) scan confirmed the diagnosis of AAA and incidentally revealed a colon adenocarcinoma and a diffuse non-Hodgkin lymphoma. This case report underlines the importance of extending the abdominal US examination to the aorta in patients over 60 years of age (especially in those people with multiple risk factors for AAA) and emphasizes the critical role of organizing hands-on-patient US courses with a multidisciplinary approach to optimize the training of future sonographers.

摘要

腹主动脉瘤(AAA)的早期检测至关重要,因为未经治疗的病变可能危及生命。我们描述了一例实习医生偶然通过超声(US)检测出AAA的病例,该病例使得随后进行了两次“多米诺骨牌”式诊断。一名69岁男性接受超声检查以评估前列腺和膀胱。他是重度吸烟者,患有高血压和血脂异常。一名内分泌科住院医生兼超声实习生偶然从上腹部开始检查,发现了一个梭形动脉瘤病变。随后的计算机断层扫描(CT)证实了AAA的诊断,并意外发现了一例结肠腺癌和弥漫性非霍奇金淋巴瘤。本病例报告强调了在60岁以上患者中(尤其是那些具有多种AAA危险因素的人群)将腹部超声检查范围扩大至主动脉的重要性,并强调了采用多学科方法组织患者实操超声课程以优化未来超声检查人员培训的关键作用。

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