腹主動脈瘤破裂以反覆性下背痛表現：病例報告

Ruptured Abdominal Aortic Aneurysm Presenting as Recurrent Lower Back Pain: Case Report

簡定國(Ting-Kuo Chien) ； 王國新(Kwo-Syin Wang) ； 張國頌(Kuo-Song Chang) ； 陳長志(Chang-Chih Chen) ； 王志平(Chih-Pin Wang) ； 盧立華(Li-Hua Lu)

《中華民國急救加護醫學會雜誌》 15卷2期 (2004/06) Pp. 64-69

https://doi.org/10.30018/JECCM.200406.0003

摘要

急性下背痛是急診常見的主訴之一，急性且反覆性發作的下背痛，常常會誤導急診醫師，而將它輕易地診斷為腎絞痛或腰部肌肉酸痛。我們報告一個75歲女性發生腹主動脈瘤破裂，其臨床表現卻是反覆性下背痛，因其陣發性疼痛合併休克現象引起腹部急症的懷疑，由腹部超音波以及電腦斷層檢查而確立診斷，再經緊急手術處理而挽回一命。因此輕忽下背痛可能會造成嚴重的錯誤，故在未詳細的評估檢查前，切不可驟下診斷。

關鍵字

下背痛 ； 腎絞痛 ； 肌肉酸痛 ； 腹主動脈瘤破裂

並列摘要

Acute lower back pain is a common chief complaint in emergency departments. Rupture of an abdominal aortic aneurysm causing sudden onset of lower back pain with recurrent attacks may mislead emergency department physicians to a diagnosis of renal colic or myalgia. We report on a case of a 75-year-old female presenting with recurrent lower back pain which turned out to be a rupture of an abdominal aortic aneurysm. Because intermittent pain was accompanied by shock, an acute abdominal condition was suspected. Rupture of an abdominal aortic aneurysm was diagnosed by ultrasound and confirmed by computed tomography. She underwent an emergency operation and recovered uneventfully. It is recommended that a more-detailed and thorough evaluation of lower back pain is mandatory. Recurrent lower back pain is usually related to renal colic and myalgia; rupture of an abdominal aortic aneurysm with such clinical presentation may be easily misdiagnosed, which could result in devastating consequences.

並列關鍵字

lower back pain ； renal colic ； myalgia ； rupture of an abdominal aortic aneurysm