Fernández González A L, Montero J A, Luna D, Gil O, Sanjuán V M, Monzonís A M
Service of Cardiac Surgery, Hospital General de Valencia, Spain.
Tex Heart Inst J. 1996;23(2):174-7.
A few patients with traumatic aortic laceration remain undiagnosed and survive long enough to develop a chronic aneurysm. Such aneurysms are frequently asymptomatic; alternatively, they may manifest themselves in the form of chest pain, dysphonia, dysphagia, bronchial irritation, or sudden death. A case of aortobronchial fistula secondary to a chronic post-traumatic aneurysm of the aortic isthmus is presented. Hemoptysis was the main sign. The affected segment of the thoracic aorta was replaced with a Dacron graft and a left superior lobectomy was performed. Nevertheless, the patient died during the postoperative period due to adult respiratory distress syndrome. Pathogenesis, diagnosis, and management of aortobronchial fistulae are discussed.
少数创伤性主动脉撕裂患者未被诊断出来,存活时间足够长,从而发展为慢性动脉瘤。此类动脉瘤通常无症状;或者,它们可能表现为胸痛、声音嘶哑、吞咽困难、支气管刺激或猝死。本文报告一例继发于主动脉峡部慢性创伤后动脉瘤的主动脉支气管瘘病例。咯血是主要症状。用涤纶补片替换胸主动脉的受累节段,并进行了左上肺叶切除术。然而,患者在术后因成人呼吸窘迫综合征死亡。文中讨论了主动脉支气管瘘的发病机制、诊断和治疗。