Saiki Munehiro, Urata Yasuhisa, Katoh Ippei, Hamasaki Takafumi
Department of Cardiovascular Surgery, Hamada Medical Center, Hamada, Japan.
Ann Thorac Cardiovasc Surg. 2006 Aug;12(4):300-2.
A 73-year-old man had lumbago of unknown cause for several months prior to presentation. At examination prior to surgery for gastric cancer, an abdominal aortic aneurysm (AAA) of 6 cm in maximum diameter, retroperitoneal hematoma and vertebral erosion were found on abdominal computed tomography (CT). Hematological examination revealed mild anemia and stable hemodynamics. A diagnosis of chronic contained rupture of an AAA was made and knitted Dacron bifurcated graft replacement was performed. When an intraluminal thrombosis at the posterior wall was removed, a punched-out defect (3 x 2 cm) was discovered. When the old hematoma was removed, a destroyed vertebral body was found. After surgery, the lumbago was alleviated. The patient was transferred to the Department of Surgery and a gastrectomy was performed. The patient's postoperative course was uneventful.
一名73岁男性在就诊前数月出现原因不明的腰痛。在接受胃癌手术前的检查中，腹部计算机断层扫描（CT）发现最大直径为6 cm的腹主动脉瘤（AAA）、腹膜后血肿和椎体侵蚀。血液学检查显示轻度贫血且血流动力学稳定。诊断为AAA慢性局限性破裂，并进行了编织涤纶分叉移植物置换术。当移除后壁的腔内血栓时，发现一个直径3×2 cm的穿孔缺损。当清除陈旧性血肿时，发现一个椎体破坏。手术后，腰痛缓解。患者被转至外科并接受了胃切除术。患者术后恢复顺利。
