未经证实:中绞痛动脉瘤破裂极为罕见。诊断可能具有挑战性,因为症状学可以归因于更常见的腹部病理。由于这种情况的罕见,只有病例报告可通知管理层。
未经证实:我们介绍了一例72岁女性患者中绞痛动脉瘤破裂,其体征和症状更多提示为急性结石性胆囊炎。在CT血管造影上证实了她共存的出血。线圈栓塞最初尝试失败。她做了剖腹手术,中绞痛动脉结扎术,和扩大的右半结肠切除术与主动脉内球囊放置紧急近端血管控制。术后,她再次出血,在再次尝试线圈栓塞失败后,通过在近端肠系膜上动脉置入覆膜支架治疗成功.她明显相关的胆囊炎用抗生素治疗并顺利缓解。
UNASSIGNED:中绞痛动脉瘤的诊断和治疗具有挑战性。管理选择包括血管内技术,开放手术,或组合方法。用于紧急血管控制的主动脉内球囊放置是一种新颖的方法,当腹腔内血管通路具有挑战性时,可以避免出血。
UNASSIGNED: Ruptured middle colic artery aneurysm is extremely uncommon. Diagnosis can be challenging, as symptomatology can be attributed to more common abdominal pathologies. Due to the rarity of this condition, only
case reports are available to inform management.
UNASSIGNED: We present the
case of a 72-year-old woman with a ruptured middle colic artery aneurysm presenting with signs and symptoms more suggestive of acute calculous cholecystitis. Her co-existing bleed was confirmed on CT angiogram. Coil embolization was initially attempted unsuccessfully. She underwent laparotomy, a middle colic artery ligation, and extended right hemicolectomy with intra-aortic balloon placement for emergency proximal vascular control. Post-operatively, she had a re-bleed that was successfully managed with covered stent placement in the proximal superior mesenteric artery after an unsuccessful re-attempt at coil embolization. Her apparent associated cholecystitis was managed with antibiotics and resolved uneventfully.
UNASSIGNED: A middle colic artery aneurysm can be challenging to diagnose and treat. Management options include endovascular techniques, open surgery, or a combination approach. Intra-aortic balloon placement for emergency vascular control is a novel approach that could avoid hemorrhage when intra-abdominal vascular access is challenging.