Bingöl Hakan, Günay Celalettin, Ozal Ertuğrul, Tatar Harun
Gülhane Military Academy, Department of Cardiovascular Surgery, Ankara, Turkey.
Ulus Travma Acil Cerrahi Derg. 2003 Oct;9(4):294-6.
Celiac artery aneurysm is a rare and its rupture is the most frequent and serious complication. The patient who underwent aneurysmectomy and aorto - celiac artery synthetic prosthesis graft interposition in another cardiovascular surgery center two years ago, was admitted to our department with complaints of fever and abdominal discomfort. Computed tomography revealed an aneurysm with 1 cm of diameter at the beginning of celiac artery and intraperitoneal hemorrhage. Acute hematocrit descent was occurred and then cardiac arrest was taken place. So, emergency thoracotomy was done. Aorta was compressed with hand and at the same time internal cardiac resuscitation was done then cross clamp was placed onto aorta. Median abdominal incision was done and ruptured celiac artery aneurysm was observed. Infected graft was removed and PTFE graft was interposed from descending aorta to a. hepatica propria, away from the infected area. During 17 months of follow-up period graft no complication was observed. We believe that because of its rarity, tendency to be asymptomatic along with high incidence of rupture, celiac artery aneurysms should not be underestimated.
腹腔干动脉瘤较为罕见,其破裂是最常见且严重的并发症。该患者两年前在另一家心血管外科中心接受了动脉瘤切除术及腹主动脉 - 腹腔干人工血管置换术,因发热和腹部不适入住我科。计算机断层扫描显示腹腔干起始部有一个直径1厘米的动脉瘤及腹腔内出血。急性血细胞比容下降,随后发生心脏骤停。于是进行了紧急开胸手术。用手压迫主动脉,同时进行心脏内复苏,然后将主动脉阻断钳夹在主动脉上。做了腹部正中切口,观察到破裂的腹腔干动脉瘤。移除感染的移植物,将聚四氟乙烯移植物从降主动脉置入肝固有动脉,远离感染区域。在17个月的随访期内,移植物未观察到并发症。我们认为,由于腹腔干动脉瘤罕见、倾向于无症状以及破裂发生率高,不应低估它。