复发性感染性腹主动脉瘤合并腹膜后脓肿误诊分析  

Analysis of Misdiagnosis of Recurrent Infectious Abdominal Aortic Aneurysm Combined with Retroperitoneal Abscess

作　　者：李志娟 庄百溪[1] 李天天 杨淼[1] LI Zhijuan;ZHUANG Baixi;LI Tiantian;YANG Miao(Department of Peripheral Vascular Diseases,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院周围血管科,北京100091

出　　处：《临床误诊误治》2024年第1期11-15,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨复发性感染性腹主动脉瘤(IAAA)的诊治措施和误诊原因、防范措施。方法回顾性分析曾误诊的复发性IAAA合并腹膜后脓肿1例的临床资料。结果本例因腰腹部疼痛多次就诊,发病时无IAAA三联征,接诊医生忽略了影像学检查的重要性,误诊为非感染性腹主动脉瘤。患者反复发生IAAA,行2次腔内治疗,并行多种多次实验室检查和影像学检查方确诊复发性IAAA合并腹膜后脓肿,最终因感染加重治疗无效死亡。结论临床医生应提高对IAAA影像学特点的认识,对于形态不规则的动脉瘤,需警惕IAAA,建议足量、长期抗感染治疗。Objective To investigate the diagnosis and treatment measures,causes of misdiagnosis and prevention measures for recurrent infectious abdominal aortic aneurysm(IAAA).Methods The clinical data of 1 patient with recurrent IAAA complicated with retroperitoneal abscess were retrospectively analyzed.Results The patient had multiple visits due to lower back and abdominal pain.The patient had no IAAA triad at the time of onset and was misdiagnosed with non-IAAA after the attending physician ignored the importance of imaging examination.The patient repeatedly developed IAAA and underwent endovascular treatment for two times,along with multiple laboratory and imaging examinations,to confirm recurrent IAAA with retroperitoneal abscess.Eventually,the patient died due to worsening infection and ineffective treatment.Conclusion Clinicians should improve the understanding of the imaging characteristics of IAAA,and for irregular aneurysms,should be alert to the possibility of IAAA,and provide sufficient and long-term anti-infection treatment.

关 键 词：主动脉瘤 腹 动脉瘤 感染性 复发 脓肿 腹膜后 布鲁菌 大肠杆菌 误诊 

分 类 号：R543.16[医药卫生—心血管疾病]