腹主动脉瘤合并输尿管受压1例

Vasile Adrian Mureșan, M. Cosarca, E. Russu, R. Niculescu, Cătălin Andrei Zăgan
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引用次数: 3

摘要

摘要简介:在此报告中,我们报告一例罕见的主动脉瘤合并左输尿管梗阻并发肾积水的病例。病例介绍:一名62岁男性因上腹部和脐周疼痛,脊柱延伸和无尿而入院。相关疾病表现为动脉高血压II/III期、慢性缺血性心肌病、酸中毒、高钾血症、颈椎病伴神经根病、急性肾功能衰竭、肾结石和进食困难。经CT扫描,诊断为巨大腹腔肾下动脉瘤伴输尿管受压,腹膜后破裂伴髂总动脉及髂内动脉闭塞。我们采用直径16 × 8mm的银涤纶血管假体行下腹-阴部剖腹手术并动脉瘤内吻合和主动脉-髂双侧旁路。道格拉斯引流术是必要的,最后进行了腹腔镜检查。患者术后进展良好。结论:鉴于血管内手术无法解决由压迫引起的问题,开放手术仍然是治疗大动脉瘤的金标准方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Rare Case of Abdominal Aortic Aneurysm with Ureteral Compression
Abstract Introduction: In this report, we present a rare case of aortic aneurysm with associated left ureter obstruction and consequent hydronephrosis. Case presentation: A 62-year-old man was admitted for epigastric and periumbilical pain, extended in the spine, and anuria. As for associated diseases, he presented arterial hypertension stage II/III, chronic ischemic cardiomyopathy, acidosis, hyperpotassemia, spondylosis with radiculopathy, acute renal failure, renal lithiasis, and eating difficulties. After performing a CT scan, the patient was diagnosed with giant abdominal infrarenal aortic aneurysm with ureter compression, and retroperitoneal rupture with common and internal iliac arteries occlusion. We performed a xifo-pubian laparotomy with endoaneurysmorrhaphy and aortoiliac bilateral bypass using silver Dacron vascular prosthesis (16 × 8 mm in diameter). Douglas drainage was necessary, ending with laparoraphy. The patient presented a favorable postoperative evolution. Conclusion: Open surgery remains the gold standard method of treatment for large aortic aneurysms, given the inability of endovascular procedures to solve problems caused by compression.
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