Jacobs D L, Freischlag J A, Seabrook G R, Towne J B
Department of Vascular Surgery, Medical College of Wisconsin, Milwaukee.
Ann Vasc Surg. 1994 Sep;8(5):491-5. doi: 10.1007/BF02133070.
Acute aortic dissection and abdominal aortic aneurysm presenting as coexistent conditions is rare. We report a patient with a history of hypertension and acute severe back pain who had an acute aortic dissection extending into a preexisting 8 cm abdominal aortic aneurysm that was diagnosed by CT scan. There was no evidence of aortic rupture or leakage. The patient was treated with antihypertensive medication for 2 months to allow maturation of the acute dissection prior to elective repair of the abdominal aortic aneurysm. The repair was constructed to allow continued perfusion of both the true and false lumina by fenestration of the aortic septum at the proximal anastomosis. There were no postoperative complications. This case illustrates an unusual combination of aortic diseases. A management plan is described that safely treats both pathologic conditions.
急性主动脉夹层与腹主动脉瘤并存的情况较为罕见。我们报告了一名有高血压病史且突发剧烈背痛的患者，其急性主动脉夹层延伸至一个已存在的8厘米腹主动脉瘤，通过CT扫描得以诊断。没有主动脉破裂或渗漏的迹象。该患者接受了2个月的抗高血压药物治疗，以使急性夹层成熟，然后择期修复腹主动脉瘤。修复手术通过在近端吻合处对主动脉隔膜进行开窗，以允许真腔和假腔持续灌注。术后无并发症。本病例说明了一种不寻常的主动脉疾病组合。描述了一种安全治疗两种病理状况的管理方案。
