双侧髂总动脉瘤的偶然诊断:病例报告和文献综述

Shailendra Katwal, Srijana Katwal, Sushmita Bhandari, Pratiksha Paudel, Devendra Bhandari, Shristi Bhandari, Santosh Maharjan
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摘要

动脉瘤是动脉的扩张,腹主动脉异位(AAE)被认为是腹主动脉瘤(AAA)的前兆。髂动脉瘤(IAA)通常伴随 AAA,具有严重的风险,尤其是由于破裂造成的风险。在此,作者介绍了一个病例,强调了识别和处理孤立的双侧髂总动脉瘤(CIAA)的重要性。 一名 66 岁的男性在一次道路交通事故(RTA)后出现脚踝和腿部疼痛。检查发现腿部有压痛,右翼有轻度压痛,并有轻度骨盆疼痛病史。生化检查显示血糖和血脂水平异常。影像学检查发现了巨大的 CIAAs,因此需要进行手术治疗。患者的骨折也得到了相应的处理。 CIAAs虽然罕见,但却很严重,通常发生在老年男性身上,其危险因素包括高龄、男性、吸烟和高血压,而糖尿病和高脂血症可能具有保护作用。虽然通常没有症状,但可导致血栓形成或破裂等并发症。诊断主要依靠影像学检查,对于较大或有症状的动脉瘤,建议进行介入治疗。 考虑高危人群的 CIAA 至关重要,并且要认识到早期发现和干预的重要性,以防止可能危及生命的并发症。通过开放手术修复或血管内治疗方案进行及时处理,对于改善患者预后至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidental diagnosis of bilateral common iliac artery aneurysms: a case report and comprehensive literature review
Aneurysms are dilatations of arteries, with abdominal aortic ectasias (AAE) considered precursors to abdominal aortic aneurysms (AAA). Iliac artery aneurysms (IAAs), often accompanying AAA, present a serious risk, particularly due to rupture. Here, the authors present a case highlighting the importance of recognizing and managing isolated bilateral common iliac artery aneurysms (CIAAs). A 66-year-old male presented following a road traffic accident (RTA) with ankle and leg pain. Examination revealed tenderness in the leg, mild right flank tenderness, and a history of mild pelvic pain. Biochemical studies showed deranged glucose and lipid levels. Imaging revealed large CIAAs, prompting surgical intervention. The patient’s fracture was also managed accordingly. CIAAs are rare but serious, typically occurring in elderly males with risk factors including advanced age, male sex, smoking, and hypertension, while diabetes and hyperlipidemia may exert protective effects. While often asymptomatic, they can lead to complications such as thrombosis or rupture. Diagnosis relies on imaging, and intervention is recommended for larger or symptomatic aneurysms. It’s crucial to consider CIAAs in high-risk individuals and recognize the significance of early detection and intervention to prevent potentially life-threatening complications. Prompt management, either through open surgical repair or endovascular options, is crucial for improving patient outcomes.
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