Presentación atípica como abdomen agudo de un aneurisma de arteria iliaca gigante imitando colescistitis y lesión renal: reporte de caso

IF 0.3 Q4 SURGERY Cirugia Cardiovascular Pub Date : 2024-03-01 DOI:10.1016/j.circv.2023.05.005
Luis Fernando Vélez-Cuorvo , Paulo Francisco Mera-Martínez , Andrea Milena Bastidas-Narváez , José Darío Portillo-Miño
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Abstract

The common iliac artery aneurysm is relatively rare, has been observed in only 2-7% of all intra-abdominal aneurysms. It is a life-threatening condition when rupture and massive bleeding occur. We report the case of a 38-year-old patient who presented to the emergency room due to abdominal pain in the right hypochondrium, jaundice in the sclera, and a positive Murphy sign, compatible with acute cholecystitis. Computerized axial tomography was performed due to an insidious clinical picture that incidentally revealed a giant aneurysm (>10 cm) in the right common iliac artery and mural thrombus. An open emergency surgical procedure was performed due to the size of the aneurysm and infection by free fluid in the cavity and repair with autologous aorto-femoral graft with a good outcome for the patient. Giant AAIC with significant renal and hepatic involvement may present atypically in clinical practice and mimic other surgical pathologies. Common iliac artery aneurysm is a disease with high morbidity and mortality since it can threaten the patient's life when the aneurysm ruptures. It should be taken into account within the differential diagnoses when the clinical manifestations are insidious.

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模拟胆囊炎和肾损伤的巨大髂动脉瘤不典型表现为急腹症:病例报告
髂总动脉瘤相对罕见,仅占所有腹内动脉瘤的 2-7%。一旦发生破裂和大量出血,就会危及生命。我们报告了一例 38 岁患者的病例,他因右下腹疼痛、巩膜黄疸和墨菲征阳性而到急诊就诊,符合急性胆囊炎的症状。由于临床表现隐匿,医生对其进行了计算机轴向断层扫描,结果意外发现右侧髂总动脉有一个巨大动脉瘤(10 厘米)和壁栓。由于动脉瘤巨大,且腔隙中的游离液体造成感染,患者接受了开腹急诊手术,并用自体主动脉-股动脉移植进行了修补,术后效果良好。巨型 AAIC 严重累及肾脏和肝脏,在临床实践中可能表现不典型,并与其他外科病变相似。髂总动脉瘤是一种发病率和死亡率都很高的疾病,因为当动脉瘤破裂时会危及患者的生命。当临床表现隐匿时,应将其纳入鉴别诊断范围。
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来源期刊
CiteScore
0.50
自引率
66.70%
发文量
109
审稿时长
69 days
期刊最新文献
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