降主动脉感染性破裂假性动脉瘤;病例报告。

IF 2.9 Q1 EMERGENCY MEDICINE Archives of Academic Emergency Medicine Pub Date : 2024-01-07 eCollection Date: 2024-01-01 DOI:10.22037/aaem.v12i1.2203
Morteza Sanei Taheri, Sayyed Mojtaba Nekooghadam, Zahra Sadat Tabatabaei, Sahar Rezaei
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引用次数: 0

摘要

主动脉炎是主动脉壁的炎症。它可由感染性和非感染性病因引起。霉菌性动脉瘤是一种罕见的严重疾病,通常需要及时使用抗生素、外科手术或血管内手术进行治疗,以防止破裂和并发症的发生。在此,我们报告了一名 66 岁的男性患者,他有糖尿病和高血压病史,因左侧偏瘫到急诊科就诊。脑磁共振成像(MRI)显示右枕叶旁和左枕叶梗塞,呈现栓塞模式。实验室分析显示红细胞沉降率(ESR)、C反应蛋白(CRP)和白细胞(WBC)水平升高。为了探究败血症的可能性,对患者进行了非对比胸部计算机断层扫描(CT),结果显示后纵隔有气体包围的软组织密度;食道破裂和感染性主动脉假性动脉瘤是鉴别诊断之一。为了确诊,医生要求进行 CT 血管造影。确诊为受感染的假性动脉瘤破裂,患者接受了开胸手术。
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Infected Ruptured Pseudo-aneurysm in Descending Aorta; a Case Report.

Aortitis is the inflammation of the aortic wall. It can be caused by both infectious and non-infectious etiologies. Mycotic aneurysm is a rare, serious medical condition and typically requires prompt treatment with antibiotics, surgical intervention, or endovascular procedures to prevent rupture and complications. Here we reported, a 66-year-old male patient with a medical history of diabetes and hypertension, who presented to the emergency department (ED) with left-sided hemiplegia. Brain magnetic resonance imaging (MRI) revealed infarction in the right parietooccipital and left occipital lobes, demonstrating an embolic pattern. laboratory analysis revealed elevated levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and white blood cell (WBC). In order to investigate the possibility of sepsis, a non-contrast chest computed tomography (CT) scan was performed, which showed a soft tissue density surrounded by gas in the posterior mediastinum; for which the rupture of esophagus and infected aorta pseudoaneurysm were among differential diagnoses. To confirm the diagnosis, CT angiography was ordered. The infected ruptured pseudo-aneurysm(s) was confirmed and patient underwent thoracotomy surgery.

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来源期刊
Archives of Academic Emergency Medicine
Archives of Academic Emergency Medicine Medicine-Emergency Medicine
CiteScore
8.90
自引率
7.40%
发文量
0
审稿时长
6 weeks
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