NEJM:主动脉钙化与肠系膜上动脉狭窄-案例报道

2016-08-11 MedSci MedSci原创

男性,62岁,因出现顽固性肠梗阻及腹痛一周余到急诊科就诊。

患者男性,62岁,因出现顽固性肠梗阻及腹痛一周余而到急诊科就诊。

 
据该患者称,他既往有过6年的持续性腹膜透析和10年的血液透析病史。

 
腹部X线检查(图A)和计算机断层扫描(图B和图C显示轴位、冠状位)显示明显的腹主动脉壁钙化(箭头处)接近完全闭塞,另外肠系膜上动脉重度狭窄。

 
超声心动图显示主动脉瓣严重狭窄并伴有中度返流,二尖瓣狭窄与关闭不全及三尖瓣返流。

会诊医师认为,该患者主动脉严重狭窄、肠系膜上动脉狭窄是肠梗阻形成的诱发因素,但是,肠系膜上动脉旁路腹主动脉全置换也可能是发病的风险因素之一。

最后,该患者进行了主动脉瓣置换术及二尖瓣、三尖瓣成形术。术后不久,该患者腹部的肠梗阻症状逐渐消退。 

原始出处:

Yoko Ito, M.D., Ph.D., and Akihiko Nogami, M.D., Ph.D. Aortic Calcification and Superior-Mesenteric-Artery Stenosis N Engl J Med 2016; 375:566August 11, 2016

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    2016-08-19 136****0753赵

    值得学习

    0

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    2016-08-14 doctorJiangchao

    继续学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1663256, encodeId=92731663256e3, content=<a href='/topic/show?id=4bae3334873' target=_blank style='color:#2F92EE;'>#动脉钙化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33348, encryptionId=4bae3334873, topicName=动脉钙化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d1d25597695, createdName=1249897bm45(暂无昵称), createdTime=Sat Jun 24 19:30:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100967, encodeId=92ee10096efa, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Fri Aug 19 15:50:00 CST 2016, time=2016-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98469, encodeId=27699846931, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Aug 14 15:49:00 CST 2016, time=2016-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98470, encodeId=b0c7984e05b, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Aug 14 15:49:00 CST 2016, time=2016-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98218, encodeId=4f0c98218b4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Aug 13 17:24:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98219, encodeId=710e98219ff, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Aug 13 17:24:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415065, encodeId=a9f4141506514, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Fri Aug 12 22:30:00 CST 2016, time=2016-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496858, encodeId=19c61496858ad, content=<a href='/topic/show?id=217b33259df' target=_blank style='color:#2F92EE;'>#动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33259, encryptionId=217b33259df, topicName=动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4ae9287436, createdName=piaojinhua, createdTime=Fri Aug 12 22:30:00 CST 2016, time=2016-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557229, encodeId=0aaf155e229fd, content=<a href='/topic/show?id=d5e281610db' target=_blank style='color:#2F92EE;'>#肠系膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81610, encryptionId=d5e281610db, topicName=肠系膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f84f14890130, createdName=zzc2216, createdTime=Fri Aug 12 22:30:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-08-14 doctorJiangchao

    继续关注

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1663256, encodeId=92731663256e3, content=<a href='/topic/show?id=4bae3334873' target=_blank style='color:#2F92EE;'>#动脉钙化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33348, encryptionId=4bae3334873, topicName=动脉钙化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3d1d25597695, createdName=1249897bm45(暂无昵称), createdTime=Sat Jun 24 19:30:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=100967, encodeId=92ee10096efa, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Fri Aug 19 15:50:00 CST 2016, time=2016-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98469, encodeId=27699846931, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Aug 14 15:49:00 CST 2016, time=2016-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98470, encodeId=b0c7984e05b, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sun Aug 14 15:49:00 CST 2016, time=2016-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98218, encodeId=4f0c98218b4, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Aug 13 17:24:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=98219, encodeId=710e98219ff, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Sat Aug 13 17:24:00 CST 2016, time=2016-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415065, encodeId=a9f4141506514, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Fri Aug 12 22:30:00 CST 2016, time=2016-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496858, encodeId=19c61496858ad, content=<a href='/topic/show?id=217b33259df' target=_blank style='color:#2F92EE;'>#动脉狭窄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33259, encryptionId=217b33259df, topicName=动脉狭窄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4ae9287436, createdName=piaojinhua, createdTime=Fri Aug 12 22:30:00 CST 2016, time=2016-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557229, encodeId=0aaf155e229fd, content=<a href='/topic/show?id=d5e281610db' target=_blank style='color:#2F92EE;'>#肠系膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81610, encryptionId=d5e281610db, topicName=肠系膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f84f14890130, createdName=zzc2216, createdTime=Fri Aug 12 22:30:00 CST 2016, time=2016-08-12, status=1, ipAttribution=)]
    2016-08-13 doctorJiangchao

    继续学习

    0

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    2016-08-13 doctorJiangchao

    继续学习

    0

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    2016-08-12 zzc2216

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