Ruptured Thoracoabdominal Aortic Aneurysm in an Elderly Patient with Colostomy on the Left Lower Abdomen.
10.4326/jjcvs.28.327
- VernacularTitle:左下腹部に人工こう門を有する高齢者胸腹部大動脈りゅう破裂の１救命例
- Author:
Hirohisa Goto
;
Jun Amano
;
Hirofumi Nakano
;
Ryo Hasegawa
;
Kuniyoshi Watanabe
;
Tamaki Takano
;
Keiji Nishimaki
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1999;28(5):327-330
- CountryJapan
- Language:Japanese
-
Abstract:
A 76-year-old man was admitted to our hospital because of sudden upper abdominal pain and shock status. The patient had undergone Miles' procedure with a colostomy on the left lower abdomen due to rectal cancer at the age of 70 years. CT scans revealed a thoracoabdominal aortic aneurysm. In view of the clinical findings, ruptured aneurysm requiring emergent operation was diagnosed. A left spiral skin incision was made, keeping away from the colostomy. An extraperitoneal approach was selected. The thoracoabdominal aorta was replaced with an artificial graft under partial extracorporeal circulation with femoral arterial and venous cannulation. The postoperative course was uneventful. No paraplegia occurred in spite of no reconstruction of the intercostal arteries due to severe atherosclerotic changes of the aortic wall. The fact that bleeding due to ruptured aneurysm was localized in the extrapleural and extrapritoneal spaces seemed to be an advantageous factor for the success in this case.
