主动脉内球囊“尾部”致肠缺血坏死一例

A Case of Intestinal Ischemic Necrosis Caused by the"Tail"of an Intra-aortic Balloon

主动脉内球囊反搏(IABP)已被广泛用于支持心原性休克、急性心肌梗死或心脏术后心功能障碍的患者。内脏缺血是IABP治疗的常见并发症之一,其发生的主要原因之一是球囊定位不当。本例患者因反复胸痛伴循环不稳定而置入IABP,2周后行冠状动脉旁路移植术,术后因腹痛行腹部平扫及增强CT,发现主动脉内球囊“尾部”遮挡肠系膜上动脉和双肾动脉开口,伴肠缺血坏死和肾缺血表现,于外院行结肠次全切除+末端回肠造口术。

Intra-aortic balloon pump(IABP)is widely used to support patients with cardiogenic shock,acute myocardial infarction,or postoperative cardiac dysfunction.Visceral ischemia is one of the common complications of IABP treatment,and one of the main reasons for the occurrence of visceral ischemia is improper positioning of the balloon.In this case,the patient underwent IABP implantation due to recurrent chest pain and circulatory instability,and patient underwent coronary artery bypass grafting two weeks later.After surgery,abdominal pain was present and a CT scan with contrast showed that the"tail"of the IABP obstructed the superior mesenteric artery and the openings of the bilateral renal arteries,and signs of intestinal and renal ischemia.Symptom was alieved post sigmoid colectomy with end ileostomy.