Infected Aneurysm Complicated with AV Fistula and Thrombosis of the Iliac Veins and Inferior Vena Cava: A Case Demonstrated with Computed Tomography

細菌性動脈瘤併發腸骨靜脈及下腔靜脈血栓和動靜脈瘻管：病例報告及在電腦斷層影像表現

劉時佐(Shi-Zuo Liu) ； 徐守民(Soa-Min Hsu) ； 詹慧倫(Hui-Lun Zhan) ； 陳慶華(Chin-Hwa Chen) ； 何子龍(Tzu-Lung Ho)

《中華放射線醫學雜誌》 34卷3期 (2009/09) Pp. 233-238

摘要

腹部動脈的細菌性動脈瘤偶爾會被發現，但是合併動靜脈瘻管及其在電腦斷層影像的表現很少被報告。手術前臨床診斷細菌性動脈瘤合併動靜脈瘻管是很困難的。我們報告一位右腸骨動脈的細菌性動脈瘤，併發動靜脈瘻管及引起雙邊的腸骨靜脈和下腔靜脈的血栓。使用顯影劑的電腦斷層及三維的電腦斷層血管影像是一種有效、非侵襲性的方法，可被用來診斷及證明細菌性動脈瘤和它相關的併發症。

並列摘要

Infected aneurysm of the abdominal artery has been found occasionally, but being accompanied with arteriovenous fistula detected by CT angiography has rarely been reported. A preoperative clinical diagnosis of infected aneurysm and arteriovenous fistula is difficult. We report a case of infected aneurysm of right common iliac artery, with the complication of arteriovenous fistula, causing thrombosis of the bilateral iliac veins and inferior vena cava. This case showed the periarterial abscess extension with partial thrombosis of iliac veins and inferior vena cava, which was not mentioned before in the literature. A contrastenhanced 64-row multiple detector CT scan with three-dimensional CT angiography is an effective, non-invasive method to detect the presence of aneurysm and its associated complications.