We report an 85-year-old woman with rupture of aneurysm of the descending thoracic aorta into the left lung. She was admitted with sudden onset back pain and hemoptysis. Emergency operation was performed to replace the ruptured descending thoracic aorta, and lower lobectomy of left lung. The left lobectomy ensured that hematoma was not left in lung, although it decreased respiratory function after operation. In addition, it decreased bleeding and operating time compared to segmental resection. She was discharged without contracting an infection in the lung or graft, although she needed tracheotomy for a time. We suggest that the lower lobectomy of lung was an important factor in saving this elderly patient with rupture of an aneurysm into the left lung.

A 73-year-old man complained of sudden severe back pain and was admitted to a community hospital on February 2, 1994. DeBakey IIIb aortic dissection was diagnosed and he was treated conservatively. He noted a pulsating mass in his abdomen on June 7, 1995 and was referred to our hospital. Because of a decrease in platelet and fibrinogen and increase in FDP, local disseminated intravascular coagulation was diagnosed. Since abdominal pain continued, impending rupture was suspected. Computed tomogram showed abdominal aortic dissection and multiple iliac aneurysms. As coagulopathy did not improved by medical treatment, we performed prosthetic graft replacement of the aortio-iliac system on September 4, 1995. Before operation, the effectiveness of heparin was confirmed. After the operation local disseminated intravascular coagulation improved without drug therapy.