Abrahamson J, Eldar S
Isr J Med Sci. 1981 Jun;17(6):426-9.
A 70-yr-old man developed acute localized and generalized symptoms and signs associated with a large aneurysm of the abdominal aorta. During an emergency operation, it was found that the aneurysm had ruptured into the inferior vena cava (IVC). The fistula was closed and the aneurysm replaced by a bifurcated synthetic graft. Important factors in the operative management were: clamping of the aorta above and the common iliac arteries below the aneurysm; opening of the aneurysm through a vertical incision; control of back bleeding through the fistula by external pressure on the IVC; closure of the fistula by a continuous braided dacron suture incorporating the walls of the aneurysm and the IVC; and replacement of the aneurysm by a bifurcated synthetic graft without excision of the aneurysm.
一名70岁男性出现了与腹主动脉大动脉瘤相关的急性局部和全身症状及体征。在急诊手术中，发现动脉瘤已破裂进入下腔静脉（IVC）。瘘口被封闭，动脉瘤被分叉的人工血管替代。手术管理中的重要因素包括：在动脉瘤上方夹闭主动脉，在其下方夹闭双侧髂总动脉；通过垂直切口打开动脉瘤；通过对下腔静脉施加外部压力来控制经瘘口的回血；用连续编织涤纶缝线封闭瘘口，缝线穿过动脉瘤壁和下腔静脉壁；不切除动脉瘤，而是用分叉的人工血管替代动脉瘤。
