The merit of rural point-of-care ultrasound: Carotid pseudoaneurysm case report.

IF 1.7 Q4 PRIMARY HEALTH CARE
Jan C Thirion, Daniël J Van Hoving
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Abstract

Introduction:  Extracranial carotid artery aneurysms and pseudoaneurysms are rare, comprising less than 4% of all peripheral artery aneurysms. Rural primary health care facilities often face significant challenges because of limited access to formal imaging. Point-of-care ultrasound (PoCUS) has the potential to bridge this gap, accelerating timely diagnosis and management in remote settings.

Patient presentation:  A 19-year-old male presented to a rural primary health care clinic in the Western Cape of South Africa with a 3-week history of left-sided neck swelling and recent odynophagia. Physical examination revealed a firm, pulsatile mass with an audible bruit.

Management and outcome:  Formal imaging was unavailable for several months, delaying surgical advice. However, the clinic's newly procured mobile ultrasound allowed for PoCUS, which identified a pulsatile vascular lesion consistent with a carotid pseudoaneurysm. Computed tomography angiography confirmed the diagnosis, and the patient was referred for tertiary care where the lesion was repaired. He had vasculitis on histology and exhibited inconclusive features of a connective tissue disorder, but a definitive cause was not found. Despite multiple attempts, he could not be contacted for follow-up.

Conclusion:  This case highlights how PoCUS can accelerate definitive management in resource-limited settings.Contribution: Point-of-care ultrasound is potentially an effective, cost-efficient diagnostic tool in rural healthcare settings but requires significant investment in equipment and training. Further research is needed to evaluate its feasibility in South African rural health systems.

Abstract Image

农村即时超声的优点:颈动脉假性动脉瘤1例报告。
颅外颈动脉动脉瘤和假性动脉瘤是罕见的,占所有外周动脉动脉瘤的不到4%。农村初级卫生保健设施往往面临重大挑战,因为获得正规成像的机会有限。即时超声(PoCUS)有可能弥补这一差距,加速远程环境中的及时诊断和管理。患者介绍:一名19岁男性,因3周的左侧颈部肿胀和近期的咽痛病史来到南非西开普省的一家农村初级卫生保健诊所。体格检查发现一个坚硬、搏动的肿块,并伴有听得见的杂音。处理和结果:几个月无法获得正式影像学检查,延迟了手术建议。然而,诊所新获得的移动超声允许PoCUS,它确定了与颈动脉假性动脉瘤一致的脉动性血管病变。计算机断层血管造影证实了诊断,患者被转诊到三级护理,病变被修复。他在组织学上有血管炎,并表现出结缔组织疾病的不确定特征,但没有找到明确的病因。尽管多次尝试,但未能联系到他进行后续采访。结论:本病例强调了PoCUS如何在资源有限的情况下加速最终管理。贡献:在农村医疗环境中,即时超声可能是一种有效的、成本效益高的诊断工具,但需要在设备和培训方面进行大量投资。需要进一步的研究来评估其在南非农村卫生系统中的可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.30
自引率
10.00%
发文量
81
审稿时长
15 weeks
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