咽旁脓肿致颈内动脉假性动脉瘤1例  

Internal carotid artery pseudoaneurysm caused by parapharyngeal abscess:A case report

作　　者：张陈光 陈旭岩[1] 吴圣[1] 冯莉莉[1] 王琰[1] 陈妤 段敏 王科[1] 宋琳琳 ZHANG Chen-guang;CHEN Xu-yan;WU Sheng;FENG Li-li;WANG Yan;CHEN Yu;DUAN Min;WANG Ke;SONG Lin-lin(Department of Emergency,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院急诊科,清华大学临床医学院,北京102218

出　　处：《北京大学学报（医学版）》2023年第6期1135-1138,共4页Journal of Peking University:Health Sciences

摘　　要：颈部假性动脉瘤多由颈部血管(颈总动脉、颈内动脉、颈外动脉等)破裂引起,其发病率低,但临床死亡率极高。创伤是引起颈部假性动脉瘤最常见的原因,也可由感染、肿瘤侵犯、颈动脉夹层破裂、颈部放疗等引起^([1-2])。现阶段临床中尚缺乏一致性诊疗指南,而由感染性因素引起颈动脉假性动脉瘤在国际中罕见,在我国尚未见报道。1病例资料患者男性,87岁,主因“颈部肿胀1周,气短2天”于2021年8月22日就诊。SUMMARY Pseudoaneurysms of the neck are seldom,and those caused by neck infections especially parapharyngeal abscess are even rarer.However,it is life-threatening and may bring sudden death due to the obstruction of airway and the pseudoaneurysms rupture.We analyzed the clinical features,diagnosis and treatment of the disease through a case summary and literature review in order to guide clinical diagnosis and treatment of pseudoaneurysms.The patient,whom we presented was an 87-year-old male and admitted in emergency of our hospital with the chief complaint of neck swelling for 7 days and shortness of breath for 2 days.Cervical ultrasound examination showed that there was an liquid dark area next to the left common carotid artery which was approximately 8.0 cm×5.0 cm,consideration of formation of left carotid artery pseudoaneurysm,and the liquid dark area which was visible on the right considered of pseudoaneurysm or infection.Angiography of neck showed a clustered high-density shadow around the bifurcation of the left carotid artery,with an overall range of approximately 65 mm×52 mm×72 mm,the pseudoaneurysms for sure,while on the right side of the lesion,mixed low density shadows with air could be seen,the parapharyngeal abscess for sure.Then he was diagnosed as the pseudoaneurysm of left internal carotid artery which was caused by parapharyngeal abscess.After tracheal intubation and anti-infection treatment,the patient died due to hemorrhagic shock of the ruptured of the pseudoaneurysm.Morever we performed literature search on PubMed,Wanfang database and CNKI with keywords of“neck pseudoaneurysm,neck infection,parapharyngeal abscess”and enrolled 10 cases.Then we summarized the clinical characteristics and treatment.We analyzed and summarized the 10 case reports,in which the number of male was 7.Among them,there were 4 pediatric,and 6 adults were enrolled overall.Most of the symptoms were neck swelling,and the diseased blood vessel was mainly the right internal carotid artery which accounted for half over

关 键 词：咽旁脓肿 颈部假性动脉瘤 感染 

分 类 号：R766.4[医药卫生—耳鼻咽喉科]