即时超声检测巨大脾动脉瘤急性破裂1例。

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Critical Ultrasound Journal Pub Date : 2018-02-01 DOI:10.1186/s13089-018-0086-3
Philippe Le Conte, David Trewick, Philippe Pes, Eric Frampas, Eric Batard
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引用次数: 2

摘要

背景:上腹部疼痛在急诊医学中是常见的,并且仍然是一个具有挑战性的情况。除了胃炎或无并发症的胆石症等良性病因外,还可能提示心肌梗死或血管疾病。在这种情况下,可以进行点护理超声(POCUS)。病例介绍:一名健康的66岁男性,无既往病史,因急症发作的胃脘痛而入院。他报告在入院前服用非甾体类抗炎药1周。他的疼痛迅速消退,体格检查没有结果。心电图和血样正常。POCUS显示位于脾脏和左肾之间的血管肿块,尺寸为80 * 74 mm,伴少量游离腹膜液。计算机断层扫描诊断为脾动脉巨大裂缝性动脉瘤。采用选择性脾动脉栓塞术对动脉瘤进行血管内排除。干预后疗程顺利,患者3天后出院回家。手术后6个月,患者未出现任何栓塞并发症。结论:身体和生物/ECG正常的自发性退行性胃痛不应该让医生放心,特别是如果患者有心血管危险因素。这些患者应考虑行POCUS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Acute fissuration of a giant splenic artery aneurysm detected by point-of-care ultrasound: case report.

Background: Epigastric pain is frequent in Emergency Medicine and remains a challenging situation. Besides benign etiologies such as gastritis or uncomplicated cholelithiasis, it could reveal myocardial infarction or vascular disease. Point-of-care ultrasound (POCUS) could be performed in such situation.

Case presentation: A healthy 66-year-old man with no previous medical history was admitted to the Emergency Department for a rapid onset epigastric pain. He reported taking non-steroidal anti-inflammatories for 1 week prior to admission. His pain had rapidly subsided and the physical examination was inconclusive. ECG and blood samples were normal. POCUS revealed a vascular mass located between the spleen and the left kidney measuring 80 * 74 mm associated with small amounts of free peritoneal fluid. Computed tomography diagnosed a fissurated giant aneurysm of the splenic artery. The aneurysm was managed emergently by endovascular exclusion by selective splenic artery embolization. The post-intervention course was uneventful and the patient was discharged home 3 days later. The patient has remained free from any complications of the embolization 6 months after the procedure.

Conclusion: Spontaneously regressive epigastric pain with a normal physical and biology/ECG should not necessarily reassure the physician, in particular if patients have cardiovascular risk factors. A POCUS should be considered for these patients.

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来源期刊
Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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