北京大学学报（医学版）2023，Vol.55Issue(6)：1135-1138,4.DOI:10.19723/j.issn.1671-167X.2023.06.028
咽旁脓肿致颈内动脉假性动脉瘤1例
Internal carotid artery pseudoaneurysm caused by parapharyngeal abscess:A case report
张陈光 1陈旭岩 1吴圣 1冯莉莉 1王琰 1陈妤 1段敏 1王科 1宋琳琳1
作者信息
- 1. 清华大学附属北京清华长庚医院急诊科,清华大学临床医学院,北京 102218
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摘要
Abstract
Pseudoaneurysms of the neck are seldom,and those caused by neck infections especially parapharyngeal abscess are even rarer.However,it is life-threatening and may bring sudden death due to the obstruction of airway and the pseudoaneurysms rupture.We analyzed the clinical features,diagnosis and treatment of the disease through a case summary and literature review in order to guide clinical diag-nosis and treatment of pseudoaneurysms.The patient,whom we presented was an 87-year-old male and admitted in emergency of our hospital with the chief complaint of neck swelling for 7 days and shortness of breath for 2 days.Cervical ultrasound examination showed that there was an liquid dark area next to the left common carotid artery which was approximately 8.0 cm × 5.0 cm,consideration of formation of left carotid artery pseudoaneurysm,and the liquid dark area which was visible on the right considered of pseudoaneurysm or infection.Angiography of neck showed a clustered high-density shadow around the bifurcation of the left carotid artery,with an overall range of approximately 65 mm × 52 mm × 72 mm,the pseudoaneurysms for sure,while on the right side of the lesion,mixed low density shadows with air could be seen,the parapharyngeal abscess for sure.Then he was diagnosed as the pseudoaneurysm of left internal carotid artery which was caused by parapharyngeal abscess.After tracheal intubation and anti-infection treatment,the patient died due to hemorrhagic shock of the ruptured of the pseudoaneurysm.Morever we performed literature search on PubMed,Wanfang database and CNKI with keywords of"neck pseudoaneurysm,neck infection,parapharyngeal abscess"and enrolled 10 cases.Then we summarized the clinical characteristics and treatment.We analyzed and summarized the 10 case reports,in which the number of male was 7.Among them,there were 4 pediatric,and 6 adults were enrolled overall.Most of the symptoms were neck swelling,and the diseased blood vessel was mainly the right internal carotid artery which accounted for half overall.All the patients underwent surgical intervention,and recovered well.So we draw the conclusion that the clinical incidence of cervical pseudoaneurysms is low and can be caused by a variety of factors,especially caused by infectious factors.When a patient has a progressive pulsating mass in the neck,the preliminary diagnosis should be made by ultrasound as soon as possible,and the aortic enhancement CT should be used to further confirm.For a patient with cervical pseudo-aneurysms caused by parapharyngeal infections,he should take operation timely combined with antibiotic treatment in time.关键词
咽旁脓肿/颈部假性动脉瘤/感染Key words
Parapharyngeal abscess/Cervical pseudoaneurysm/Inflammation分类
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张陈光,陈旭岩,吴圣,冯莉莉,王琰,陈妤,段敏,王科,宋琳琳..咽旁脓肿致颈内动脉假性动脉瘤1例[J].北京大学学报（医学版）,2023,55(6):1135-1138,4.
