Bahar Ilknur G, Tutun Ufuk, Iscan Zafer, Ayabakan Nurcan, Ozdemir Mustafa
Cardiovascular Surgery Clinic, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey
Cardiovascular Surgery Clinic, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
Vascular. 2016 Dec;24(6):668-670. doi: 10.1177/1708538115627939. Epub 2016 Jan 19.
We present a case of aneurysm rupture from severe blunt abdominal trauma due to fight in a patient who had endovascular aneurysm repair. The patient presented to the emergency service with computed tomography evidence of an endoleak and a large retroperitoneal hematoma. The contrast abdominal computed tomography demonstrated a type Ib endoleak, increase in the aneurysm diameter and hematoma in the retroperitoneum. The patient has been taken under interventional procedure for endovascular aneurysm repair revision under urgent condition. Type Ib endoleak was treated by placement of a covered iliac extension limb, but a second leakage from graft body was found in control computed tomography images and open surgical conversion was necessary. Operative findings included a type III endoleak from graft body, defect on fabric. It was seen that the aneurysm sac anterior and posterior parts were ruptured. Upon reviewing the literature, we found that it was an interesting case as the first rupture case which had been developed after severe blunt abdominal trauma during the follow-up period of a patient on which endovascular aneurysm repair procedure had been performed and progressed in this manner.
我们报告了一例接受血管内动脉瘤修复术的患者因斗殴导致严重钝性腹部创伤后动脉瘤破裂的病例。该患者因计算机断层扫描显示存在内漏和巨大腹膜后血肿而被送往急诊。腹部增强计算机断层扫描显示为Ib型内漏、动脉瘤直径增大以及腹膜后血肿。患者在紧急情况下接受了血管内动脉瘤修复术的介入性翻修手术。Ib型内漏通过放置带覆膜的髂部延长肢体进行治疗,但在对照计算机断层扫描图像中发现移植物主体出现二次渗漏,因此有必要转为开放手术。手术发现包括移植物主体出现III型内漏、织物上有缺损。可见动脉瘤囊的前部和后部均已破裂。在查阅文献时,我们发现这是一个有趣的病例,因为这是首例在接受血管内动脉瘤修复术的患者随访期间因严重钝性腹部创伤而发生破裂并如此发展的病例。