- 期刊
Left Massive Hemothorax Caused by Celiac Artery Aneurysm Rupture-A Case Report
腹腔動脈瘤破裂導致左側大量血胸－病例報告
摘要
腹腔動脈瘤在臟器血管瘤中相當少見。大多數被診斷的病人都有症狀或是意外被發現。在此我們介紹一位患者初期表現出上腹痛及嘔吐，之後出現左側血胸。在急診初期被懷疑為食道破裂引起血胸，但經過進一步影像學檢查及上消化道內視鏡檢查後，懷疑為腹腔動脈瘤破裂併左側血胸。患者因血液動力學相對穩定，因此計畫先觀察後再安排至血管外科治療。但在住院期間，即因再次腹痛追蹤電腦斷層檢查，腹腔動脈瘤明顯增大，並有後腹腔血腫。因此安排血管支架手術治療，術後患者順利出院，共住院二十一天。在此我們回顧文獻關於腹腔動脈瘤的報告相當少，而以上腹痛後併嘔吐左側血胸的表現容易與食道破裂混淆。因此在診斷此類患者時要相當謹慎，並小心的處理病人。
並列摘要
Celiac artery aneurysm (CAA) is a rare form of visceral artery aneurysm. Most patients are diagnosed as having CAA when they are symptomatic or incidentally detected. We present the case of a 31-year-old female who had epigastric discomfort followed by left massive hemothorax after nausea, and vomiting with hematemesis. She was first diagnosed with esophageal rupture. After further examination, CAA with rupture was suspected. Severe epigastric pain developed on day 9 after hospitalization. Aortic stenting with a superior mesenteric artery (SMA) chimney and embolization of the pseudoaneurysm were performed. Antibiotics were prescribed, and she was then discharged uneventfully. We reviewed the literature regarding the symptoms, diagnosis and treatment of CAA. The incidence of CAA is low, and the symptoms of epigastric pain followed by left massive hemothorax after vomiting could be confused with esophageal rupture initially. We should keep this uncommon disease in mind and deal with patients carefully.
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