Nomura M, Kitagawa K, Fujimura M, Matsuda T
Second Department of Internal Medicine, Koseiren Takaoka Hospital, Takaoka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Sep;33(9):1009-12.
A 65-year-old man with Rendu-Osler-Weber syndrome was admitted to the department of brain surgery at our hospital because of left hemiplegia and a right cerebral mass seen on a computerized tomogram of the brain. A brain abscess was found during surgery. Then the patient had pneumonia. He received antibiotics and recovered, but his PaO2 remained low. He was transferred to our department for evaluation of hypoxia. Thoracic computerized tomography showed a nodular lesion connected to a vascular shadow. Angiographic examination showed a pulmonary arteriovenous fistula and other vascular abnormalities. He was not dyspneic or cyanotic, but his hypoxia, low diffusing capacity, and brain abscess were thought to be caused by the pulmonary arteriovenous fistula. The fistula was embolized with coils via a percutaneous catheter, after which oxygenation and diffusing capacity improved.
一名65岁患有遗传性出血性毛细血管扩张症（Rendu-Osler-Weber综合征）的男性因左侧偏瘫以及脑部计算机断层扫描显示右侧脑内肿块而入住我院脑外科。手术中发现一个脑脓肿。随后患者发生肺炎。他接受了抗生素治疗并康复，但他的动脉血氧分压（PaO2）仍较低。他被转至我科以评估缺氧情况。胸部计算机断层扫描显示一个与血管影相连的结节性病变。血管造影检查显示有一个肺动静脉瘘及其他血管异常。他没有呼吸困难或发绀，但他的缺氧、低弥散能力和脑脓肿被认为是由肺动静脉瘘引起的。通过经皮导管用弹簧圈对瘘进行了栓塞，之后氧合和弥散能力得到改善。
