Shin Hong Kyung, Park Jae Young, Lee Taeseung
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Vasc Specialist Int. 2014 Jun;30(2):72-5. doi: 10.5758/vsi.2014.30.2.72. Epub 2014 Jun 30.
A 78-year-old male presented with early gastric cancer and a 5.5 cm-sized infrarenal abdominal aortic aneurysm, detected during regular screening. Endovascular aneurysm repair (EVAR) was performed first, followed by laparoscopic distal gastrectomy. After gastrectomy, the patient underwent computed tomography (CT) scan due to persistent fever, which showed increased perigraft fluid collection around the right iliac limb graft. Echocardiography also revealed mitral valve vegetation, consistent with infective endocarditis. Despite intensive antibiotic treatment, the patient had persistent fever and showed fluid extension to the psoas muscle on CT scan. On the 49th post operative day (POD) after EVAR, stent graft explantation and aortic reconstruction with the left superficial femoral vein was performed. Ligation of the right iliac artery for infection control and simultaneous femoro-femoral bypass was also performed. The patient was discharged on the 46th POD after graft removal without any events.
一名78岁男性在定期筛查中被发现患有早期胃癌和一个5.5厘米大小的肾下腹主动脉瘤。首先进行了血管内动脉瘤修复术（EVAR），随后进行了腹腔镜远端胃切除术。胃切除术后，患者因持续发热接受了计算机断层扫描（CT），结果显示右髂支移植物周围的移植物周围积液增加。超声心动图还显示二尖瓣赘生物，符合感染性心内膜炎。尽管进行了强化抗生素治疗，患者仍持续发热，CT扫描显示积液延伸至腰大肌。在EVAR术后第49天（POD），进行了支架移植物取出术并用左股浅静脉进行主动脉重建。还进行了右髂动脉结扎以控制感染并同时进行股-股旁路手术。患者在移植物取出术后第46天POD出院，无任何并发症。
