Yamamoto Hiroshi, Yamamoto Fumio, Fukuhiro Yoshiaki, Yamaura Gembu, Ishibashi Kazuyuki, Motokawa Mamika, Tanaka Fuminobu
Department of Cardiovascular Surgery, Akita University School of Medicine, Japan.
Ann Thorac Cardiovasc Surg. 2011;17(2):204-7. doi: 10.5761/atcs.cr.10.01551.
An 84-year-old woman with a history of surgery for cholangiocarcinoma presented to Akita University Hospital with severe right lower abdominal pain, respiratory distress, and hypotension. Computed tomography scanning revealed a ruptured right common iliac artery aneurysm with a massive right retroperitoneal hematoma and a right internal iliac artery aneurysm. Under the bilateral retroperitoneal approach, we preformed an in-situ repair of an aneurysm rupture from the aorta to the left common and right external iliac arteries using a bifurcated knitted Dacron graft, and then we ligated the right internal iliac artery. The postoperative course of the patient was uneventful. The patient was discharged from hospital 52 days after surgery. In conclusion, a bilateral retroperitoneal approach may be a safe and useful strategy for in-situ repair of a right iliac artery aneurysm rupture in patients with peritoneal adhesions after transperitoneal abdominal surgery.
一名有胆管癌手术史的84岁女性因严重右下腹痛、呼吸窘迫和低血压就诊于秋田大学医院。计算机断层扫描显示右髂总动脉瘤破裂，伴有巨大的右腹膜后血肿和右髂内动脉瘤。在双侧腹膜后入路下，我们使用分叉编织涤纶移植物对从主动脉到左髂总动脉和右髂外动脉的动脉瘤破裂进行了原位修复，然后结扎了右髂内动脉。患者术后恢复顺利。患者在手术后52天出院。总之，对于经腹手术后有腹膜粘连的患者，双侧腹膜后入路可能是原位修复右髂动脉瘤破裂的一种安全有效的策略。
