Hioki M, Takei H, Masuda S, Iedokoro Y, Shoji T
Second Department of Surgery, Nippon Medical School, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1991 Oct;92(10):1524-7.
A 68-year-old man was admitted to our hospital because of shock. CT scan revealed ruptured abdominal aortic aneurysm (AAA) with isolated left-sided inferior vena cava (L-IVC). After emergent laparotomy, maintaining blood pressure stable, we clamped the aorta at the level of the supra-celiac region. An AAA (8.5cm in diameter) leaking from the posterior wall with a retroperitoneal hematoma was found, and L-IVC pressed by AAA was identified. The AAA was dissected with caution so as not to injure L-IVC and replaced with a woven Dacron bifurcated graft. The postoperative course was uneventful. The embryonic development and clinical significance of this rare anomaly are discussed. This is the first successful case in the Japanese literature by our survey.
一名68岁男性因休克入住我院。CT扫描显示腹主动脉瘤(AAA)破裂并伴有孤立的左侧下腔静脉(L-IVC)。急诊剖腹手术后,在维持血压稳定的情况下,我们在腹腔干上方区域夹闭了主动脉。发现一个直径8.5厘米的腹主动脉瘤,后壁渗漏并伴有腹膜后血肿,同时识别出被腹主动脉瘤压迫的左侧下腔静脉。小心地解剖腹主动脉瘤以免损伤左侧下腔静脉,并用编织涤纶分叉移植物进行置换。术后过程顺利。讨论了这种罕见异常的胚胎发育及临床意义。据我们调查,这是日本文献中的首例成功病例。