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[一例肠系膜下动脉大动脉瘤。病例报告及文献复习]

[A large aneurysm of the inferior mesenteric artery. Apropos of a case. Review of the literature].

作者信息

Lagneau P, Charlier A, Gaux J C, Guize L

出版信息

J Mal Vasc. 1984;9(2):143-7.

PMID:6747477
Abstract

The prevalence of inferior mesenteric aneurysms is difficult to evaluate in the literature, only four cases having been published up to the present. The case described here was a large aneurysm of the inferior mesenteric artery measuring 10 cm by 8 cm of atheromatous origin, discovered echotomographic investigation of an abdominal mass and confirmed by aortography. Operation consisted in endoaneurysmorrhaphy with reimplantation of the main branch supplying the sigmoid arteries into the aorta combined with reimplantation of the right common iliac eroded by the aneurysm into the right side of the aorta. This type of lesion raises two problems: diagnostic: echotomography and digitalised angiography will certainly facilitate the detection of such lesions, the risk of rupture of which is considerable; therapeutic: distal reimplantation of the inferior mesenteric artery which is decided on the basis of its anatomical state and above all the superior mesenteric and coeliac collateral circulation in order to avoid any risk of ischaemia of the descending colon.

摘要

肠系膜下动脉瘤的患病率在文献中难以评估,目前仅有4例病例被报道。此处描述的病例是一例源自动脉粥样硬化的肠系膜下动脉大动脉瘤,大小为10厘米×8厘米,通过腹部肿块的超声断层检查发现,并经主动脉造影证实。手术包括动脉瘤内缝术,即将供应乙状结肠动脉的主要分支重新植入主动脉,同时将被动脉瘤侵蚀的右髂总动脉重新植入主动脉右侧。这类病变引发两个问题:诊断方面,超声断层检查和数字化血管造影肯定有助于此类病变的检测,其破裂风险相当大;治疗方面,肠系膜下动脉的远端重新植入术要根据其解剖状态,尤其是肠系膜上动脉和腹腔动脉的侧支循环来决定,以避免降结肠出现任何缺血风险。

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