Cates J R
J Manipulative Physiol Ther. 1997 Oct;20(8):557-61.
To review the presentation, diagnosis and management of aortic aneurysms. Case reports and a brief topic review are presented.
Three cases of aneurysm that were diagnosed in a chiropractic office are discussed. An aneurysm is defined as an abnormal dilation of the aorta as a result of atherosclerosis, genetic predisposition and/or acquired biochemical alterations in the wall of the aorta. The "classic triad," hypotension, back pain and a pulsatile abdominal mass are present in only 50% of those people with ruptured abdominal aortic aneurysms (AAA). Large unruptured aneurysms are quite often asymptomatic and are often found incidentally on physical or X-ray examination. History, palpation, auscultation and imaging are all helpful in diagnosing AAAs, and all are readily available in a chiropractic office.
Surgical intervention is generally considered appropriate in AAAs > 5 cm in diameter. All patients recovered after surgical repair of the aneurysm.
Chiropractors can perform simple diagnostic procedures to differentially diagnosis and screen for AAAs. Such screening measures may yield a statistical decrease in deaths caused by rupture of aortic aneurysms.
回顾主动脉瘤的临床表现、诊断及治疗。现呈现病例报告及简短的专题综述。
讨论了在整脊诊所诊断出的三例动脉瘤病例。动脉瘤被定义为由于动脉粥样硬化、遗传易感性和/或主动脉壁后天性生化改变导致的主动脉异常扩张。“典型三联征”，即低血压、背痛和搏动性腹部肿块，仅出现在50%的腹主动脉瘤（AAA）破裂患者中。大型未破裂动脉瘤通常无症状，常在体格检查或X线检查时偶然发现。病史、触诊、听诊和影像学检查均有助于诊断AAA，且在整脊诊所均可方便进行。
直径大于5厘米的AAA通常考虑进行手术干预。所有患者在动脉瘤手术修复后均康复。
整脊医师可进行简单的诊断程序以鉴别诊断和筛查AAA。此类筛查措施可能会使主动脉瘤破裂导致的死亡人数在统计学上有所减少。
