Dissecting hematoma

Introduction A mezzanine hematoma is not really a tumor, but it protrudes outward like a tumor. It refers to a fatal disease in which the circulating blood penetrates into the arterial dissection to form a hematoma.

Cause

The causes are very complicated, such as: hypertension, arteriosclerosis, trauma, inflammation, genetic abnormalities, etc. Among them, hypertension and arteriosclerosis are the most important.

an examination

Related inspection

Ultrasound diagnosis of cardiovascular disease cardiovascular disease

1. When performing cardiovascular angiography, it can be found that in the bulging part of the arteries, after the contrast agent is injected, the arterial lumen is narrowed and the artery wall is thickened. The contrast agent can enter the arterial dissection through a gap in the arterial wall, so that the true and false lumens appear as two parallel dense ducts with a fine translucent line separation. If there is a thrombus in the pseudo-cavity of the dissecting aneurysm, it cannot or does not fill the contrast agent.

2, ultrasound examination, you can find the double lumen changes in the blood vessels.

Differential diagnosis

The symptoms of dissection hematoma need to be identified as follows.

First, aortic aneurysm:

1. The symptoms of aortic aneurysm are caused by compression, traction, and erosion of surrounding tissues, depending on the size and location of the aortic aneurysm. Thoracic aortic aneurysm swells in the facial, neck and shoulder veins when the superior vena cava is compressed, and may have edema; coughing and shortness of breath caused by compression of the trachea and bronchus; compression of the esophagus causes difficulty in swallowing; compression of the recurrent laryngeal nerve causes hoarseness.

2, X-ray performance:

(1) The mediastinal shadow of the medial and lateral chest radiographs can be widened, and the aorta is locally or extensively bulged. If the calcification of the aortic intima is observed, the distance from the outer edge of the aorta is widened (normally 3 mm). , suggesting the possibility of a dissection aneurysm.

(2) Organs adjacent to the aorta, such as the trachea, esophagus, or abdominal organs, are displaced by the bulging aorta.

(3) Increased heart shadow, weakened pulsation indicates pericardial hemorrhage or heart failure.

(4) 20%-25% of the dissection aneurysm can break into the left thoracic cavity, showing a rapidly increasing pleural effusion.

Second, atherosclerosis:

Mainly determined by the degree of ischemia of vascular lesions and affected organs, aortic atherosclerosis is often asymptomatic, coronary atherosclerosis, if the diameter of the tube is more than 75%, angina, myocardial infarction, arrhythmia, and even sudden death. Cerebral arteriosclerosis can cause cerebral ischemia, brain atrophy, or cerebral vascular rupture, renal atherosclerosis often causes nocturia, refractory hypertension, severe cases may have renal insufficiency. Mesenteric atherosclerosis can be manifested as symptoms such as abdominal pain and blood in the stool after a meal. Lower extremity atherosclerosis caused severe stenosis of the vascular lumen may occur intermittent claudication, the dorsal artery pulsation disappeared, and even severe gangrene may occur.

(1) Patients often have elevated blood cholesterol, triglycerides, high-density lipoprotein, and abnormal lipoprotein electrophoresis patterns. Most patients present with type III or type IV hyperlipoproteinemia.

(2) X-ray examination shows that the aorta is elongated, dilated and distorted, and sometimes calcium is seen.

(3) Arteriography can show the stenosis, lesions and extent of the quadriple artery, renal artery and coronary artery caused by atherosclerosis.

(4) Doppler ultrasound examination is helpful to judge the blood flow of the arteries and renal arteries of the extremities.

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