罕见囊状上腔静脉瘤成功手术治疗1例

Case report of successful surgical removal of a rare saccular aneurysm of the superior vena cava

目的手术切除罕见囊状上腔静脉瘤病例。方法回顾性分析惠州市第一人民医院2020年9月16日收治的1例囊状上腔静脉瘤病人的临床资料。病人有吞咽异物感,胸部CT以及CT增强重建提示囊状上腔静脉瘤,大小约59 mm×58 mm×46 mm。病人在全麻下进行上腔静脉瘤切除术。结果手术顺利,切除上腔静脉肿瘤后连续缝合加固静脉壁,并用自体心包组织包裹上腔静脉以保护静脉壁。病理诊断为囊状上腔静脉瘤。病人术后恢复良好,痊愈出院。术后2个月(2020年11月24日)随访未见静脉瘤复发。结论巨大囊状上腔静脉瘤应该采取预防性手术切除以防止血管破裂、血栓形成或静脉阻塞。

Objective Case report of surgical removal of a rare saccular aneurysm of the superior vena cava.Methods Retrospective analysis of the clinical data of a patient with cystic superior vena cava aneurysm in Huizhou First Hospital in September 16,2020 was performed.A patient with chief complaint of the sensation of a foreign body in the throat during swallowing underwent chest CT and CT enhanced reconstruction.A 59 mm×58 mm×46 mm cystic superior vena cava aneurysm was detected.The aneurysm was surgically removed under general anesthesia.Results The operation was successful.The incision was continuously sutured,strengthened,and wrapped with the patient's own pericardial tissue to protect the wall of superior vena cava.The pathological diagnosis was aneurysm of the superior vena cava.The patient recovered well and was discharged.Two month later,a follow-up chest CT scan was performed in November 24,2020 and showed no abnormalities.Conclusion For a huge saccular aneurysm of the superior vena cava,prophylactic surgical resection is recommended to prevent rupture,thrombosis or venous obstruction.