BMJ:腹股沟动脉搏动性肿块不是动脉瘤,还能是什么?——案例报道

2016-10-26 MedSci MedSci原创

患者男,61岁,运动时左侧腹股沟和大腿疼痛。检查显示左股三角区域内有一个深的圆形肿块,表现为动脉搏动。想一想,腹股沟动脉搏动性肿块,有哪些可能?动脉搏动性...难道是动脉瘤?不过进一步的超声检查结果排除了动脉瘤的可能。那么会是肿瘤吗?毕竟一听到肿块,大多数人的第一反应会是“肿瘤吗?”接下来进行了磁共振检查,结果如下图所示:T2加权磁共振图像证实,这是一个大的左腰大肌囊,来自有骨关节炎的髋关节,显然

患者男,61岁,运动时左侧腹股沟和大腿疼痛。

检查显示左股三角区域内有一个深的圆形肿块,表现为动脉搏动。

想一想,腹股沟动脉搏动性肿块,有哪些可能?

动脉搏动性...难道是动脉瘤?

不过进一步的超声检查结果排除了动脉瘤的可能。

那么会是肿瘤吗?毕竟一听到肿块,大多数人的第一反应会是“肿瘤吗?”

接下来进行了磁共振检查,结果如下图所示:



T2加权磁共振图像证实,这是一个大的左腰大肌囊,来自有骨关节炎的髋关节,显然是取代股血管。

注意一点:它们突出的脉动很容易被误认为为是一个潜在的动脉瘤。

不过之前的超声检查已经排除了动脉瘤的可能性。

除了发现左腰大肌囊,磁共振图像还显示同侧闭孔囊,和间接的右腹股沟疝。

所以同志们,以后遇到腹股沟动脉搏动性肿块,除了动脉瘤,还要想一想会不会是腰大肌囊。

原始出处:

Nicholas Raoul Francesco Lagattolla,et al.An unusual cause of a mass in the groin.BMJ 2016;355:i5147 


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    2017-04-04 gaoxiaoe
  2. [GetPortalCommentsPageByObjectIdResponse(id=1848138, encodeId=8581184813847, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 04 04:45:00 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412005, encodeId=50dc141200587, content=<a href='/topic/show?id=951b82e63ff' target=_blank style='color:#2F92EE;'>#肿块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82763, encryptionId=951b82e63ff, topicName=肿块)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c58f2824468, createdName=cnxcy, createdTime=Fri Oct 28 14:45:00 CST 2016, time=2016-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151480, encodeId=d00c151480ba, content=搞血管介入的,首先想到动脉瘤~动静脉瘘~静脉瘤之类的,确实没想到是这个?,以后要加强学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuNPuRsh496XQldy9rzb9voMjVNp8mXmVhoxvricpqWO4EqVEiajRxgV2iczWuYFckVBWcTu4M8ticZTZ/0, createdBy=3a8e1649586, createdName=1ddc435am67(暂无匿称), createdTime=Thu Oct 27 09:40:23 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151423, encodeId=6d50151423dd, content=谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Oct 27 06:28:06 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151419, encodeId=30e315141926, content=长知识啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b1121972078, createdName=1e162dd0m18(暂无匿称), createdTime=Thu Oct 27 05:13:40 CST 2016, time=2016-10-27, status=1, ipAttribution=)]
    2016-10-28 cnxcy
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    2016-10-27 1ddc435am67(暂无匿称)

    搞血管介入的,首先想到动脉瘤~动静脉瘘~静脉瘤之类的,确实没想到是这个?,以后要加强学习?

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1848138, encodeId=8581184813847, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 04 04:45:00 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412005, encodeId=50dc141200587, content=<a href='/topic/show?id=951b82e63ff' target=_blank style='color:#2F92EE;'>#肿块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82763, encryptionId=951b82e63ff, topicName=肿块)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c58f2824468, createdName=cnxcy, createdTime=Fri Oct 28 14:45:00 CST 2016, time=2016-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151480, encodeId=d00c151480ba, content=搞血管介入的,首先想到动脉瘤~动静脉瘘~静脉瘤之类的,确实没想到是这个?,以后要加强学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuNPuRsh496XQldy9rzb9voMjVNp8mXmVhoxvricpqWO4EqVEiajRxgV2iczWuYFckVBWcTu4M8ticZTZ/0, createdBy=3a8e1649586, createdName=1ddc435am67(暂无匿称), createdTime=Thu Oct 27 09:40:23 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151423, encodeId=6d50151423dd, content=谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Oct 27 06:28:06 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151419, encodeId=30e315141926, content=长知识啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b1121972078, createdName=1e162dd0m18(暂无匿称), createdTime=Thu Oct 27 05:13:40 CST 2016, time=2016-10-27, status=1, ipAttribution=)]
    2016-10-27 刘煜

    谢谢分享。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1848138, encodeId=8581184813847, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue Apr 04 04:45:00 CST 2017, time=2017-04-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412005, encodeId=50dc141200587, content=<a href='/topic/show?id=951b82e63ff' target=_blank style='color:#2F92EE;'>#肿块#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82763, encryptionId=951b82e63ff, topicName=肿块)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c58f2824468, createdName=cnxcy, createdTime=Fri Oct 28 14:45:00 CST 2016, time=2016-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151480, encodeId=d00c151480ba, content=搞血管介入的,首先想到动脉瘤~动静脉瘘~静脉瘤之类的,确实没想到是这个?,以后要加强学习?, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuNPuRsh496XQldy9rzb9voMjVNp8mXmVhoxvricpqWO4EqVEiajRxgV2iczWuYFckVBWcTu4M8ticZTZ/0, createdBy=3a8e1649586, createdName=1ddc435am67(暂无匿称), createdTime=Thu Oct 27 09:40:23 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151423, encodeId=6d50151423dd, content=谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Oct 27 06:28:06 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151419, encodeId=30e315141926, content=长知识啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b1121972078, createdName=1e162dd0m18(暂无匿称), createdTime=Thu Oct 27 05:13:40 CST 2016, time=2016-10-27, status=1, ipAttribution=)]
    2016-10-27 1e162dd0m18(暂无匿称)

    长知识啊

    0