Iwai T, Sato S, Muraoka Y, Inoue Y, Sugano N, Endo M
1st Department of Surgery, School of Medicine, Tokyo Medical and Dental University, Japan.
Int Surg. 1996 Apr-Jun;81(2):189-94.
Fourteen saccular abdominal aortic protrusion patients (ages ranged from 55 to 84, mean age 69.1 years) were reported. Their lesions were pathologically or bacteriologically suggested to be of atherosclerotic origin. Other origins were eliminated by using the patients past history or physical and diagnostic examination. All patients were classified into 1 of 3 types; solitary, adjacent to fusiform AAA, and independent of fusiform AAA. Diagnosis and surgical techniques were complicated when coexisting with a fusiform abdominal aortic aneurysm (AAA) and located in the AAA neck. The treatment of choice for 13 patients was surgery. Postoperatively two patients died of hepatic failure at 5 weeks, and from apoplexia at four months, after surgery, respectively. The remaining patients' prognosis is good after a 3-month to 6-year follow-up with a mean period of 2.9 years except 1 medically treated patient. Accordingly, atherosclerotic abdominal aorta saccular protrusion should be carefully diagnosed and be surgically treated in the usual AAA manner. Only juxtarenal saccular protrusions require careful reconstruction, preserving the renal or visceral function.
报告了14例腹主动脉囊状突出患者（年龄55至84岁，平均年龄69.1岁）。其病变经病理或细菌学检查提示为动脉粥样硬化起源。通过患者既往病史、体格检查及诊断性检查排除了其他起源。所有患者分为3种类型之一：孤立型、与梭形腹主动脉瘤相邻型、与梭形腹主动脉瘤无关型。当与梭形腹主动脉瘤（AAA）并存且位于AAA颈部时，诊断和手术技术较为复杂。13例患者的首选治疗方法是手术。术后2例患者分别于术后5周死于肝功能衰竭和4个月死于中风。除1例接受药物治疗的患者外，其余患者在平均2.9年（3个月至6年）的随访后预后良好。因此，对于动脉粥样硬化性腹主动脉囊状突出应仔细诊断，并以常规AAA的方式进行手术治疗。只有肾旁囊状突出需要仔细重建，以保留肾脏或内脏功能。
