Chambon J P, Fournier A, Saudemont A, Quandalle P
Clinique Chirurgicale Adultes Ouest, Hôpital Claude Huriez, CHRU, Lille.
J Chir (Paris). 1995 Oct;132(10):371-4.
Isolated iliac aneurysms are often discovered when they rupture, sometimes into a neighbouring organ. We report 2 cases of aneurysm of the common iliac artery, one which ruptured into the right common iliac vein and the other in to the sigmoid. Diagnosis was made at laparotomy in the first case and on the CT-scan of the pelvis in the second. The first case was treated with an exclusion graft using ilio-iliac bypass with suture of the venous breach via the aneurysm. In the second case, the aneurysm was excluded by ligature of the iliac arteries with extra-anatomic crossed femoro-femoral bypass, sigmoid colostomy and drainage of the pelvis. These two cases illustrate the importance of digital examination of the pelvis and CT-scan for the diagnosis of complicated aneurysms of the iliac vessels. Rapid surgery is a determining factor in prognosis.
孤立性髂动脉瘤常在破裂时才被发现，有时会破入邻近器官。我们报告2例髂总动脉瘤，1例破入右髂总静脉，另1例破入乙状结肠。第1例在剖腹手术时确诊，第2例通过骨盆CT扫描确诊。第1例采用髂-髂旁路血管移植术进行旷置性 graft（此处原文graft含义不明，可能有误，推测为修复之类意思），经动脉瘤缝合静脉裂口。第2例通过结扎髂动脉、行解剖外交叉股-股旁路移植术、乙状结肠造口术及盆腔引流来排除动脉瘤。这两例说明了盆腔指诊和CT扫描对诊断复杂髂血管动脉瘤的重要性。快速手术是预后的决定性因素。
