Hassan D, Ulmer B G, McFadden D
Department of Surgery, Royal University Hospital, Saskatoon, Sask.
Can J Surg. 1996 Feb;39(1):67-9.
Isolated internal iliac aneurysms are rare, and although most are of atherosclerotic origin the cause may also be congenital, traumatic, associated with pregnancy or infectious. A 56-year-old man presented with a swollen, painful left lower limb. Within a few days, weakness of the limb developed with fever and an acute abdomen with free air on x-ray. At emergency laparotomy a small perforation was found in the ascending colon. Examination of the left iliac fossa revealed a ruptured left internal iliac artery aneurysm. Extra-anatomic cross-femoral bypass grafting was done to revascularize the left lower extremity. The patient recovered without complication. At discharge the weakness had improved but knee flexion and extension were weak. Culture of the aneurysm contents grew Staphylococcus aureus and Pseudomonas aeruginosa. The authors discuss the presentation and management of infected internal iliac artery aneurysms.
孤立性髂内动脉瘤较为罕见，虽然大多数起源于动脉粥样硬化，但病因也可能是先天性、创伤性、与妊娠相关或感染性的。一名56岁男性因左下肢肿胀、疼痛就诊。数天内，该肢体出现无力，并伴有发热和急性腹痛，X线显示有游离气体。在急诊剖腹手术中，发现升结肠有一个小穿孔。检查左髂窝时发现左髂内动脉动脉瘤破裂。进行了解剖外股交叉旁路移植术以使左下肢血管再通。患者康复，无并发症。出院时，无力症状有所改善，但膝关节屈伸仍较弱。动脉瘤内容物培养出金黄色葡萄球菌和铜绿假单胞菌。作者讨论了感染性髂内动脉动脉瘤的临床表现及治疗。
