摘要
目的 探讨腹主动脉瘤肠瘘的诊断和治疗。方法 报告 1例腹主动脉瘤肠瘘的诊治经过 ,并复习有关文献。结果 本例为 5 0岁女性患者 ,因腹痛 2个月 ,外院剖腹探查发现腹主动脉瘤 5d入院。术后 13d突然发作上腹部剧痛 ,伴休克及上消化道大出血 ,疑诊为腹主动脉瘤肠瘘。急诊手术发现腹主动脉瘤近端空肠瘘 ,行腹主动脉瘤切除“人”形人造血管置换 ,十二指肠第 4段及空肠上段切除 ,空肠 -十二指肠降段侧侧吻合术。术后双下肢足背动脉搏动良好 ;唯持续高热 ,经抗生素治疗痊愈出院。结论 该病罕见 ,死亡率可达30 %以上。及时诊断和治疗是提高本病生存率的关键。由于腹主动脉与肠道相通 ,术后易发生败血症及腹膜后感染 。
Objective To study the diagnosis and treatment of abdominal aortic anurysm-intestinal fistula(AAA-IF). Methods The diagnosis and treatment of one patient with AAA-IF was reported, while a literateres review of AAA-IF was made. Results A 50 years old femal patient abmitted due to upper abdominal pain for two month, and an AAA was found in the explore laparotomy. The patient suddenly occurred severe upper abdominal pain accompanied with shock and massive upper gastrointestinal bleeding 13 days after the operation. The preoperative suspected diagnosis was AAA-IF. An AAA-IF was ound during emergent operation. AAA-IF resection with artifial vessel replacement, resection of the forth portion of duodenal and upper portion of jejunal were performed together. The patient recovered eventurely except high body temperature. After vigovous antibiotics therapy, the patient recovered. Conclusions AAA-IF is a rare disordor, the mortality can be as high as over 30%. The key points of redecing mortality are that the diagnosis and treatment should be in time; postoperative vigorous antibiotics should be given, because the AAA-IF patient tends to occur septic complications due to the communication occurred between the AAA and intestinal tract.
出处
《中国普通外科杂志》
CAS
CSCD
2001年第5期426-428,共3页
China Journal of General Surgery
关键词
主动脉瘤
并发症
肠瘘
继发性
AORTIC ANEURYSM/compl
INTESTINAL FISTULA/second
