Sekundarna venska aneurizma kao posledica intravenozne zloupotrebe narkotika

  • Miroslav Marković Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
  • Marko Dragaš Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
  • Igor Končar Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
  • Igor Banzić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
  • Siniša Pejkić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
  • Nikola Fatić Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
  • Lazar Davidović Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP140617026M
Ključne reči: aneurysm||, ||aneurizma, saphenous vein||, ||v.saphena, diagnosis, differential||, ||dijagnoza, diferencijalna, histological techniques||, ||histološke tehnike, injections, intravenous||, ||injekcije, intravenske, opioid-related disorders||, ||poremećaji izazvani opiodima, vascular surgical procedures||, ||hirurgija, vaskularna, procedure,

Sažetak


Uvod. Venska aneurizma je retko patološko stanje koje se može pojaviti kako na površnom, tako i na sistemu dubokih vena. Sekundarne venske aneurizme, kao i venske pseudoaneurizme, najčešće se javljaju kao posledica spoljne, neretko jatrogene traume. S obzirom na nisku učestalost, one se često ne prepoznaju i shodno tome nepravilno leče. Moguće komplikacije uključuju trombozu, flebitis, plućni tromboembolizam, pa čak i rupturu. Prikaz bolesnika. Prikazali smo sekundarnu vensku aneurizmu lokalizovanu na velikoj veni safeni kod mlade narkomanke, kao posledicu dugotrajnog uzimanja intravenoznih narkotika preko prepone. Aneurizma je zahtevala hitno hirurško lečenje usled akutne hemoragijske komplikacije, zbog toga što je prethodno bila punktirana pod dijagnozom suspektnog hematoma, odnosno apscesa, od strane opšteg hirurga. Učinjena je potpuna resekcija aneurizme, uz očuvanje kontinuiteta safenske vene. Postoperativni tok je protekao bez komplikacija, a uredna protočnost vene safene potvrđena je kontrolnim ultrasonografskim pregledom. Zaključak. Venske aneurizme su retke, naročito one sekundarne etiologije. Ukoliko dosegnu značajan prečnik ili prete komplikacijama, potrebno je hirurško lečenje.


Reference

May R, Nissel R. Aneurysma der Vena poplitea. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 1968; 108(3): 402−3. (German)

Pascarella L, Al-Tuwaijri M, Bergan JJ, Mekenas LM. Lower ex-tremity superficial venous aneurysms. Ann Vasc Surg 2005; 19(1): 69−73.

Seery JM, Reyes AM, Rice RD, Dodge AN, Armstrong PJ. Primary venous aneurysms: two case reports. Am Surg 2010; 76(2): 224−5.

Ward WH, Platz TA, Pond KT, Southern FA, Moore EM. Iatro-genic venous pseudoaneurysm: case report and review of the literature. Vascular 2009; 17(6): 355−8.

Karahan M, Isbir S, Baltacyoglu F, Caglar MM. False aneurysm of the common femoral vein in a footballer. Br J Sports Med 2005; 39(2): e8.

Schummer W, Schummer C, Voigt R, Heyne J, Steenbeck J. Pseudoaneurysm - a rare complication of internal jugular vein cannulation: two case reports in livertransplant patients. Anasthesiol Intensivmed Noftallmed Schmerzther 2003; 38(8): 542−6. (German)

Sessa C, Nicolini P, Perrin M, Farah I, Magne JL, Guidicelli H. Management of symptomatic and asymptomatic popliteal ve-nous aneurysms: a retrospective analysis of 25 patients and re-view of the literature. J Vasc Surg 2000; 32(5): 902−12.

Debnath D, Wallace S, Mylona E, Myint F. Aneurysm of antecu-bital vein: an unusual complication of peripheral intravenous cannulation. BMC Surgery 2007; 7(1): 9.

Schatz IJ, Fine G. Venous aneurysms. N Engl J Med 1962; 266: 1310−2.

Lev M, Saphir O. Endophlebohypertrophy and phlebosclerosis. I. The popliteal vein. AMA Arch Pathol 1951; 51(2): 154−78.

Castle JM, Arous EJ. Femoral vein aneurysm: a case report and review of the literature. Cardiovasc Surg 1995; 3(3): 317−9.

Salour M, Dattilo JB, Mingloski PM, Brewer WH. Femoral vein pseudoaneurysm: uncommon complication of femoral vein puncture. J Ultrasound Med 1998; 17(9): 577−9.

Dahl JR, Freed TA, Burke MF. Popliteal vein aneurysm with re-current pulmonary thromboemboli. JAMA 1976; 236(22): 2531−2.

Johnson JE, Lucas CE, Ledgerwood AM, Jacobs LA. Infected ve-nous pseudoaneurysm. A complication of drug addiction. Arch Surg 1984; 119(9): 1097−8.

Objavljeno
2017/03/07
Broj časopisa
Vol. 73 Br. 5 (2016)
Rubrika
Prikaz bolesnika