一例急性主动脉综合征伴血性胸腔积液的病例报告及文献回顾
A Case Report and Literature Review of Acute Aortic Syndrome with Bloody Pleural Effusion
DOI: 10.12677/ACM.2024.141275, PDF,   
作者: 郭 浩：山东大学医学融合与实践中心，山东 济南；吴学君*：山东第一医科大学附属省立医院血管外科，山东 济南
关键词: 穿透性主动脉溃疡；主动脉夹层；急性主动脉综合征；主动脉硬化；血性胸腔积液；Penetrating Aortic Ulcer； Aortic Dissection； Acute Aortic Syndrome； Aortic Sclerosis； Bloody Pleural Effusion
摘要: 急性主动脉综合征(acute aortic syndromes AAS)是一系列危及生命的疾病，包括经典的急性主动脉夹层(acute aortic dissection AAD)、壁内血肿(intramural hematoma IMH)、穿透性动脉粥样硬化性主动脉溃疡(penetrating atherosclerotic aortic ulcer PAU)。这些疾病具有共同的病理生理途径，可以同时存在，引起一系列临床症状。现汇报一例急性主动脉综合征伴血性胸腔积液的病例，并总结该类疾病目前诊治方法。
Abstract: Acute aortic syndromes (AAS) are a series of life-threatening diseases. These include classic acute aortic dissection (AAD), intramural hematoma IMH, penetrating atherosclerotic aortic ulcer aortic ulcer PAU). These diseases share a common pathophysiological pathway and can exist simultane-ously, causing a range of clinical symptoms. We report a case of acute aortic syndrome with bloody pleural effusion and summarize the current diagnosis and treatment of this disease.
文章引用：郭浩, 吴学君. 一例急性主动脉综合征伴血性胸腔积液的病例报告及文献回顾[J]. 临床医学进展, 2024, 14(1): 1950-1957. https://doi.org/10.12677/ACM.2024.141275

参考文献

[1] Kamalakannan, D., Rosman, H.S. and Eagle, K.A. (2007) Acute Aortic Dissection. Critical Care Clinics, 23, 779-800. [Google Scholar] [CrossRef] [PubMed]
[2] Oderich, G.S., Kärkkäinen, J.M., Reed, N.R., et al. (2019) Penetrat-ing Aortic Ulcer and Intramural Hematoma. Cardiovascular and Interventional Radiology, 42, 321-334. [Google Scholar] [CrossRef] [PubMed]
[3] Bossone, E. and Eagle, K.A. (2021) Epidemiology and Manage-ment of Aortic Disease: Aortic Aneurysms and Acute Aortic Syndromes. Nature Reviews. Cardiology, 18, 331-348. [Google Scholar] [CrossRef] [PubMed]
[4] Filiberto, A.C., Ramadan, O.I., Wang, G.J., et al. (2023) Sex Disparities in Patients with Acute Aortic Dissection: A Scoping Review. Seminars in Vascular Surgery, 36, 492-500. [Google Scholar] [CrossRef] [PubMed]
[5] Tsai, T.T., Nienaber, C.A. and Eagle, K.A. (2005) Acute Aortic Syndromes. Circulation, 112, 3802-3813. [Google Scholar] [CrossRef] 
[6] Erbel, R., Aboyans, V., Boileau, C., et al. (2014) 2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases: Document Covering Acute and Chronic Aortic Diseases of the Thoracic and Abdominal Aorta of the Adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). European Heart Journal, 35, 2873-2926. [Google Scholar] [CrossRef] [PubMed]
[7] Ganaha, F., Miller, D.C., Sugimoto, K., et al. (2002) Prognosis of Aortic Intramural Hematoma with and without Penetrating Atherosclerotic Ulcer: A Clinical and Radiological Analysis. Circulation, 106, 342-348. [Google Scholar] [CrossRef] 
[8] DeCarlo, C., Latz, C.A., Boitano, L.T., et al. (2021) Natural History of Penetrating Atherosclerotic Ulcers in Aortic Branch Vessels. Journal of Vascular Surgery, 74, 1904-1909. [Google Scholar] [CrossRef] [PubMed]
[9] Isselbacher, E.M., Preventza, O., Hamilton Black, J., et al. (2022) 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation, 146, E334-E482. [Google Scholar] [CrossRef] 
[10] Siegel, Y. (2013) Penetrating Atherosclerotic Aortic Ulcer Rupture Causing a Right Hemothorax; a Rare Presentation of Acute Aortic Syndrome. The American Journal of Emer-gency Medicine, 31, 755.e5-755.e7. [Google Scholar] [CrossRef] [PubMed]
[11] Velissaris, T.J., Lloyd, C.T. and Ohri, S.K. (2002) Type B Aortic Dissection and Right Hemothorax. Asian Cardiovascular & Thoracic Annals, 10, 197. [Google Scholar] [CrossRef] [PubMed]
[12] Takago, S., Tang, G.H.L., Barnes, H.J., et al. (2021) Thoracic Endovascular Aortic Repair of a Ruptured Acute Type B Aortic Dissection Presenting with Right Hemothorax: A Case Report and Review of the Literature. General Thoracic and Cardiovascular Surgery, 69, 1438-1443. [Google Scholar] [CrossRef] [PubMed]
[13] Eckholdt, C., Pennywell, D., White, R.K., et al. (2023) Unusual Presentation of Acute Ruptured Penetrating Aortic Ulcer of Descending Thoracic Aorta with Right Hemothorax. Journal of Vascular Surgery Cases and Innovative Techniques, 9, Article ID: 101176. [Google Scholar] [CrossRef] [PubMed]
[14] Siegal, E.M. (2006) Acute Aortic Dissection. Journal of Hospital Medicine, 1, 94-105. [Google Scholar] [CrossRef] [PubMed]
[15] Wu, S., Cao, C., Lun, Y., et al. (2022) Age-Related Dif-ferences in Acute Aortic Dissection. Journal of Vascular Surgery, 75, 473-483.e4. [Google Scholar] [CrossRef] [PubMed]
[16] Morello, F., Santoro, M., Fargion, A.F., et al. (2021) Diagnosis and Management of Acute Aortic Syndromes in the Emergency Department. Internal and Emergency Medicine, 16, 171-181. [Google Scholar] [CrossRef] [PubMed]
[17] Tadros, R.O., Tang, G.H.L., Barnes, H.J., et al. (2019) Optimal Treatment of Uncomplicated Type B Aortic Dissection: JACC Review Topic of the Week. Journal of the American Col-lege of Cardiology, 74, 1494-1504. [Google Scholar] [CrossRef] [PubMed]
[18] Nienaber, C.A. and Clough, R.E. (2015) Management of Acute Aortic Dissection. The Lancet (London, England), 385, 800-811. [Google Scholar] [CrossRef] 
[19] Nienaber, C.A., Kische, S., Rousseau, H., et al. (2013) Endovascular Repair of Type B Aortic Dissection: Long-Term Results of the Randomized Investigation of Stent Grafts in Aortic Dissection Trial. Circulation. Cardiovascular Interventions, 6, 407-416. [Google Scholar] [CrossRef] 
[20] Jae Sung, C. and Makaroun, M.S. (2008) Commentary: Tsai TT, Fattori R, Trimarchi S, et al. Long-Term Survival in Patients Presenting with Type B Acute Aortic Dissection: Insights from the International Registry of Acute Aortic Dissection. Circulation. 2006; 114: 2226-2231. Per-spectives in Vascular Surgery and Endovascular Therapy, 20, 95-96. [Google Scholar] [CrossRef] [PubMed]
[21] Vilacosta, I., San RomáN, J.A., et al. (2021) Acute Aortic Syn-drome Revisited: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 78, 2106-2125. [Google Scholar] [CrossRef] [PubMed]
[22] Augoustides, J.G. (2022) Commentary: Acute Type B Aortic Dis-section: Navigating New Horizons. The Journal of Thoracic and Cardiovascular Surgery, 164, 1066-1067. [Google Scholar] [CrossRef] [PubMed]
[23] Harris, K.M., Braverman, A.C., Eagle, K.A., et al. (2012) Acute Aortic Intramural Hematoma: An Analysis from the International Registry of Acute Aortic Dissection. Circulation, 126, S91-S96. [Google Scholar] [CrossRef] 
[24] Blanchard, D.G. and Sawhney, N.S. (2004) Aortic Intramural Hematoma: Current Diagnostic and Therapeutic Recommendations. Current Treatment Options in Cardio-vascular Medicine, 6, 99-104. [Google Scholar] [CrossRef] [PubMed]
[25] Bansal, S., Singhania, N., Yadav, M., et al. (2020) A Penetrating Aortic Ulcer. The Journal of Emergency Medicine, 59, e25-e26. [Google Scholar] [CrossRef] [PubMed]
[26] 秦艳, 徐峰. 胸腔引流管在成人创伤性血胸中的研究进展[J]. 中国现代医生, 2023, 61(21): 114-116.
[27] Morgan, C.K., Bashoura, L., Balachandran, D., et al. (2015) Spontaneous Hemothorax. Annals of the American Thoracic Society, 12, 1578-1582. [Google Scholar] [CrossRef] 
[28] Jonker, F.H.W., Verhagen, H.J.M., Lin, P.H., et al. (2010) Outcomes of Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysms. Circulation, 121, 2718-2723. [Google Scholar] [CrossRef] 
[29] Shu, C., He, H., Li, Q.M., et al. (2011) Endovascular Repair of Complicated Acute Type-B Aortic Dissection with Stentgraft: Early and Mid-Term Re-sults. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vas-cular Surgery, 42, 448-453. [Google Scholar] [CrossRef] [PubMed]
[30] Piffaretti, G., Menegolo, M., Kahlberg, A., et al. (2015) Hemothorax Management after Endovascular Treatment for Thoracic Aortic Rupture. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery, 50, 608-613. [Google Scholar] [CrossRef] [PubMed]

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