腰部椎間盤突出合併腹主動脈瘤破裂：病例報告暨文獻回顧

Lumbar Disc Herniation along with Ruptured Abdominal Aortic Aneurysm: A Case Report and Literature Review

吳宛錞(Woan-Chwen Wu) ； 周正亮(Chen-Liang Chou) ； 袁明琦(Ming-Chi Yung) ； 陳行素(Shing-Su Chen) ； 劉作仁(Tcho-Jen Liu) ； 詹瑞棋(Rai-Chi Chan)

《中華民國復健醫學會雜誌》 29卷4期 (2001/12) Pp. 227-233

https://doi.org/10.6315/JRMA.200112.0227

摘要

腹部主動脈瘤於老年人的發生率約4%左右，其症狀有很多，包括腹痛及背痛，而以下半身麻痺來表現則非常少見。由文獻回顧，合併腰部椎間盤突出及腹部主動脈瘤破裂的病例報告到目前為止只有數例報告。在此我們提出一位68歲男性罹患一未被診斷出來的腹部主動脈瘤，及合併腰部椎間盤突出並且接受腰椎牽引，直到突然發生下半身癱瘓才發現原來是腹部主動脈瘤破裂。經開刀修補後，雖保住了生命，但仍遺留了下半身癱瘓及大小便失禁的後遺症，於住院期間又併發了深部靜脈栓塞。希望藉此病例報告提醒各位醫師，對於罹患腰部椎間盤突出症的患者突然發生不尋常的下背痛，應考慮到是否合併主動脈瘤等其他會危及生命的疾病，以免因人為的疏失而延誤診斷。此外，對於深部靜脈栓塞的診斷與治療，本文亦做一概略性介紹。

關鍵字

腰部椎間盤突出 ； 腹部主動脈瘤破裂 ； 癱瘓 ； 深部靜脈拴塞

並列摘要

Abdominal aortic aneurysm is a condition affecting nearly 4% of the elderly population. It has a potential for producing a wide range of symptoms, including abdominal pain and back pain. It is rare that abdominal aortic aneurysm presents with paraplegia. From literature review there have been very few reports of patients who sustained lumbar disc herniation along with ruptured abdominal aortic aneurysm. We reported a 68-year-old man with a previously undiagnosed abdominal aortic aneurysm presenting with acute paraplegia. This patient had a history of lumbar disc herniation and was receiving pelvic traction. He survived after operation, but some long-term sequelae, such as paraplegia and incontinence, still persisted. Moreover, deep vein thrombosis developed during the admission. Based on this case report, abdominal aortic aneurysm should be kept in mind when patients inflicted with low back pain, because delayed diagnosis may be associated with a poor outcome. In addition, the diagnosis and management of deep vein thrombosis are introduced in this article.

並列關鍵字

lumbar disc herniation ； ruptured abdominal aortic aneurysm ； paralysis ； deep vein thrombosis