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頁籤選單縮合
題名 | Infected Aneurysm of The Superficial Femoral Artery: A Case Report=感染性表淺股動脈瘤--病例報告 |
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作者 | 連守揚; 周治剛; 林伯彥; 姚仲勉; 葉明煌; 李天植; 董宏一; | 書刊名 | 臺灣急診醫學會醫誌 |
卷期 | 8:4 民95.12 |
頁次 | 頁142-146 |
分類號 | 416.263 |
關鍵詞 | 感染性動脈瘤; 動脈創傷; 心內膜炎; 沙門氏菌; Infected aneurysm; Arterial trauma; Endocarditis; Salmonella; |
語文 | 英文(English) |
中文摘要 | 感染性動脈瘤是一種不常見,但卻有高死亡率的疾病。最常見的原因是:動脈創傷及心內膜炎,最常見感染性動脈瘤的動脈是:股動脈及腹主動脈。早期診斷感染性動脈瘤仍舊是急診醫師的挑戰。我們報告一位長期服用類固醇控制風溼性關節炎的病患,因右大腿腫痛送至本院急診就醫。該病人全血球計數顯示白血球過多,右大腿X光顯示產氣性肌肉壞死,電腦斷層顯示沿著股內收肌有體液及空氣聚集,於緊急手術中發現感染性動脈瘤破裂,並且於病人的血液培養出沙門氏菌。為了病患最好的預後,急診醫師必須有高度的懷疑、早期適當的放射線評估、積極廣效性的抗生素使用、以及儘早外科照會。 |
英文摘要 | Infected aneurysms are uncommon and have a high mortality. The two most common etiologies are arterial trauma and endocarditis. The most commonly affected artery is the femoral artery, followed by the abdominal aorta. Early diagnosis continues to be a challenge for emergency physicians. We report on a patient with rheumatoid arthritis under long-term steroid control who suffered from pain and swelling in the right thigh. Because of rapid development of pain and swelling, he was sent to our emergency department. The complete blood count revealed leukocytosis. Radiographs of the right thigh revealed diffuse gas forming myonecrosis. Computed tomography revealed fluid collection and air pockets along the deep fascia of the adductor muscles. Rupture of an infected aneurysm was noted during emergency surgery. Blood cultures were positive for Salmonella enteritidis group B. Emergency physicians must have a high index of suspicion of this condition, and early appropriate radiological evaluation, aggressive antibiotic usage and prompt surgical consultation are needed to obtain the best outcome. |
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