Nicolaou D D, Mysko W K
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287-2080, USA.
Am J Emerg Med. 1996 May;14(3):272-5. doi: 10.1016/S0735-6757(96)90175-8.
A 78-year-old man with a history of recent unexplained lower gastrointestinal bleeding presented to the emergency department with the acute onset of abdominal pain, tenesmus, and shock. Computed tomography of the abdomen showed a fistula between a common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm of the common and proximal internal iliac arteries with fistulous communication to the distal ileum. Aneurysmectomy, arteriorrhaphy, and segmental ileal resection with primary anastomosis were successfully performed. This case illustrates a rare complication of an uncommon aneurysm, emphasizing the need for emergency physicians to consider complicated vascular disease in the evaluation of a patient with abdominal pain and shock.
一名78岁男性，近期有不明原因的下消化道出血病史，因突发腹痛、里急后重和休克就诊于急诊科。腹部计算机断层扫描显示髂总动脉瘤与小肠之间存在瘘管。剖腹探查发现髂总动脉和髂内动脉近端有一个囊状动脉瘤，与回肠远端有瘘管相通。成功实施了动脉瘤切除术、动脉修补术以及回肠节段性切除并一期吻合术。该病例说明了一种罕见动脉瘤的罕见并发症，强调急诊医生在评估腹痛和休克患者时需要考虑复杂的血管疾病。
