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[腹主动脉感染性动脉瘤与沙门菌败血症。经切除及腋双股动脉旁路移植术治疗的一例患者2年的良好转归]

[Infectious aneurysm of the abdominal aorta and Salmonella septicemia. Favorable development over 2 years of a case treated by resection and axillobifemoral bypass].

作者信息

Devolfe C, Barral X, Lescoeur N, Ninet J, Descotes J, Pasquier J

出版信息

J Mal Vasc. 1982;7(4):339-44.

PMID:6897656
Abstract

A 57 years old man had a two months history of chills and fever with abdominal pain. Blood cultures were positive for Salmonella ohio. He suddenly became hypotensive with oedema of lower limbs. Angiographic findings were infrarenal aortic rupture with pseudoaneurysm formation and inferior vena cava compression. After ligation of the aorta and both common iliac arteries, an axillo-bi-femoral graft was constructed to bypass the infection area. Subsequent occurrence of lumbar osteomyelitis required debridement and drainage of retroperitoneum. The patient was discharged on oral amoxicilline given for eleven months. Two years postoperatively he is able to walk without evidence of further infection. With a review of 32 other cases in the literature, emphasis is placed on theories of pathogenesis and on modes of surgical management.

摘要

一名57岁男性有两个月的寒战、发热伴腹痛病史。血培养显示俄亥俄沙门氏菌阳性。他突然出现低血压并伴有下肢水肿。血管造影结果显示肾下腹主动脉破裂并形成假性动脉瘤,以及下腔静脉受压。在结扎主动脉和双侧髂总动脉后,构建了腋-双股人工血管以绕过感染区域。随后发生的腰椎骨髓炎需要进行清创和腹膜后引流。患者出院时口服阿莫西林,持续服用11个月。术后两年,他能够行走,无进一步感染迹象。通过回顾文献中的其他32例病例,重点讨论了发病机制理论和手术治疗方式。

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