同时进行与癌症相关的乙状结肠穿孔和直径76毫米腹主动脉瘤的手术。
Simultaneous operation for cancer-related sigmoid colon perforation and abdominal aortic aneurysm of 76 mm in diameter.
作者信息
Tsutsumi Ryosuke, Hiyoshi Yukiharu, Matsumoto Takuya, Oki Eiji, Morita Masaru, Maehara Yoshihiko
机构信息
Department of Surgery and Science Graduate School of Medical Sciences Kyushu University Fukuoka Japan.
出版信息
Acute Med Surg. 2015 Aug 27;3(2):182-185. doi: 10.1002/ams2.134. eCollection 2016 Apr.
CASE
A 92-year-old woman was emergently admitted to our hospital for peritonitis caused by sigmoid colon cancer perforation, with a coexistent abdominal aortic aneurysm of 76 mm in diameter.
OUTCOME
A 92-year-old woman was admitted to the hospital with a complaint of abdominal pain and fever of 24-h duration. On physical examination, severe tenderness with muscular defense and a palpable, pulsating mass were detected in the upper abdomen. The patient was diagnosed as having panperitonitis caused by sigmoid colon perforation. Computed tomography also revealed an infrarenal abdominal aortic aneurysm of 76 mm in diameter. We performed endovascular aneurysm repair to prevent aneurysmal rupture in the perioperative period and simultaneously performed intra-abdominal drainage and Hartmann's operation. The patient's postoperative course was uneventful.
CONCLUSION
Simultaneous endovascular aneurysm repair and operation for peritonitis is considered a possible treatment strategy for patients at high risk of abdominal aortic aneurysm rupture.
病例
一名92岁女性因乙状结肠癌穿孔导致腹膜炎紧急入院，同时存在直径76毫米的腹主动脉瘤。
结果
一名92岁女性因持续24小时的腹痛和发热入院。体格检查发现上腹部有严重压痛、肌卫，可触及搏动性肿块。患者被诊断为乙状结肠穿孔引起的全腹膜炎。计算机断层扫描还显示肾下腹主动脉瘤直径为76毫米。我们进行了血管内动脉瘤修复术以防止围手术期动脉瘤破裂，同时进行了腹腔引流和哈特曼手术。患者术后恢复顺利。
结论
对于腹主动脉瘤破裂高危患者，血管内动脉瘤修复术与腹膜炎手术同时进行被认为是一种可行的治疗策略。
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