Galessiere P F, Downs A R, Greenberg H M
Department of Surgery, University of Manitoba, Winnipeg.
Can J Surg. 1994 Feb;37(1):23-8.
Chronic, contained rupture of aortic aneurysms is an important subset of ruptured aneurysms. Their presentation is unusual, and the diagnosis may be delayed. The associated vertebral erosion may contribute to the difficulty in diagnosis. The courses of three patients with chronic, contained rupture of an aortic aneurysm associated with vertebral erosion are presented. In each case the presentation was unusual and the initial diagnosis delayed. Computed tomography demonstrated the contained rupture and vertebral erosion in all cases. Microorganisms were cultured from all three aneurysms. Repair was successful in all cases. Contained rupture of an aortic aneurysm should be considered in older patients with unexplained back pain, and the possibility of this condition should not be ignored when there is a history of arthritic back pain or a radiograph suggestive of degenerative disease. Urgent surgical repair is indicated to prevent lethal, uncontrolled hemorrhage.
慢性局限性主动脉瘤破裂是破裂性动脉瘤的一个重要亚型。其表现不常见，诊断可能会延迟。相关的椎体侵蚀可能导致诊断困难。本文介绍了3例伴有椎体侵蚀的慢性局限性主动脉瘤破裂患者的病程。每例患者的表现均不寻常，初始诊断均延迟。计算机断层扫描在所有病例中均显示出局限性破裂和椎体侵蚀。所有3个动脉瘤均培养出微生物。所有病例的修复均成功。对于有不明原因背痛的老年患者，应考虑主动脉瘤局限性破裂，当有脊柱关节炎背痛病史或X线片提示退行性疾病时，不应忽视这种情况的可能性。应进行紧急手术修复以防止致命的、无法控制的出血。
