Baste J C, Midy D, Pheline P, Dassain M, Ghessens B, Alessandrin J F
Service de Chirurgie générale et vasculaire, hôpital Saint-André, Bordeaux.
Chirurgie. 1994;120(4):198-200; discussion 201.
We report two new cases of aneurysms of the sub-renal aorta in which rupture was followed by a chronic clinical course. In the first, there was an atheromatous aneurysm which led to chronic lombo-sciatic pain over a period of 15 months before exact diagnosis. The second concerned an aneurysm probably related to Yersinia enterolitica infection which led to abdominal pain over a period of 3 weeks. In both cases, the diagnosis was made on the CT scan and the operation led to the immediate disappearance of the symptomatology. Although a particular entity of sub-renal aorta aneurysms is still under debate, identifying an identifiable subset appears to be justified. Indeed, cases in which a chronic course follows rupture have particular characteristics including the absence of effect on general haemodynamics and an operative risk identical to nonruptured aneurysms. These characteristics differentiate this subset from non-sealed retroperitoneal aneurysms of the aorta.
我们报告了两例肾下腹主动脉瘤的新病例，其破裂后呈现慢性临床病程。第一例为动脉粥样硬化性动脉瘤，在准确诊断前的15个月里导致慢性腰腿痛。第二例是一个可能与小肠结肠炎耶尔森菌感染相关的动脉瘤，在3周时间里引发腹痛。两例均通过CT扫描确诊，手术使症状立即消失。尽管肾下腹主动脉瘤的一个特定类型仍存在争议，但确定一个可识别的亚组似乎是合理的。确实，破裂后呈现慢性病程的病例具有特殊特征，包括对全身血流动力学无影响以及手术风险与未破裂动脉瘤相同。这些特征将该亚组与未封闭的主动脉腹膜后动脉瘤区分开来。
