ANEURISMA INFECIOSO DO TRONCO CELÍACO — UMA ENTIDADE CLÍNICA RARA
DOI:
https://doi.org/10.48750/acv.149Palavras-chave:
Aneurisma infecioso, Aneurisma micótico, Tronco celíacoResumo
Introdução: O aneurisma infecioso do tronco celíaco é um diagnóstico extremamente raro, com apenas alguns casos reportados até à data. Pretendeu-se assim realizar uma revisão da literatura relativa a esta entidade clínica, com enfâse nas estratégias de diagnósticas e terapêuticas.
Métodos: Uma revisão de literatura foi realizada utilizando a base de dados da MEDLINE de acordo com as recomendações PRISMA.
Resultados: No total foram identificados 11 casos de aneurisma infecioso do tronco celíaco. As opções de tratamento foram extremamente variáveis englobando cirurgia aberta e endovascular. A primeira incluiu laqueação do aneurisma ou aneurismectomia com ou sem revascularização com bypass. As opções endovasculares incluíram embolização do aneurisma e colaterais, exclusão com recurso a stentgraft do aneurisma e num caso a técnica de Chimney foi usada para excluir o aneurisma mantendo a permeabilidade do tronco celíaco. Antibioterapia foi consistentemente uma parte essencial da estratégia terapêutica.
Conclusões: Dada a raridade do aneurisma infecioso do tronco celíaco, a sua história natural não é conhecida. Não obstante, a decisão de tratamento cirúrgico, independentemente do tamanho do aneurisma, é unânime. Os resultados a curto prazo do tratamento endovascular são encorajadores, mas a implantação endovascular de material protésico num ambiente infetado torna a antibioterapia de duração indeterminada aconselhável.
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