一名患有医院恐惧症的70岁昏迷男子被送往我们医院。抵达后,他表现出意识障碍,不稳定的循环,和低温状态。根据临床症状,全身计算机断层扫描(CT)的结果,和生化研究,他被诊断为尿脓毒血症(由膀胱肠瘘引起),高血糖危机,感染性腹主动脉瘤(iAAA),胆囊结石诱发的胰腺炎,多器官衰竭.他接受了支持治疗。腹部磁共振图像(MRI)显示腹主动脉瘤(AAA)伴有炎性主动脉壁,主动脉炎性淋巴结肿大,和主动脉周围脂肪炎症。他的意识暂时恢复了,但他不同意接受手术。第28天,他突然崩溃了。我们介绍了一例由膀胱肠瘘和/或急性胰腺炎引起的尿脓毒症引起的iAAA的致命病例。并发多器官衰竭。在老龄化社会,医生不仅要了解疾病的病因,还要了解病理的严重程度,并确定老年患者的致命并发症。
A 70-year-old unconscious man with hospital phobia was transported to our hospital. On arrival, he displayed consciousness disturbance, unstable circulation, and a hypothermic state. Based on the clinical symptoms, the results of whole body computed tomography (CT), and biochemical studies, he was diagnosed with urosepsis (induced by vesico-enteric fistula), hyperglycemic crisis, infectious abdominal aortic aneurysm (iAAA), gallbladder stone-induced pancreatitis, and multiple organ failure. He was treated with supportive therapy. The abdominal magnetic resonance image (MRI) revealed an abdominal aortic aneurysm (AAA) with an inflammatory aortic wall, paraaortic inflammatory lymph node swelling, and periaortic fat inflammation. His consciousness temporarily recovered, but he did not agree to undergo surgery. On day 28, he suddenly collapsed. We present a fatal case of iAAA induced by urosepsis from vesico-enteric fistula and/or acute pancreatitis, complicated by multiple organ failure. In aging societies, physicians should explore not only the cause of disease but also the severity of the pathology and define fatal complications in elderly patients.