Kajikawa T, Satoh S, Banya Y, Fujioka T, Kubo T
Department of Urology, Iwate Medical University School of Medicine.
Hinyokika Kiyo. 1995 Feb;41(2):141-3.
A case of fatal hemorrhage caused by rupture of the external iliac artery aneurysm into the urinary bladder is presented. The patient, a 58-year-old Japanese female, had undergone total hysterectomy, and post-operative therapeutic radiation, for uterine cancer in 1974. A vesicocecal fistula was observed, and surgical intervention for closure was performed in May, 1992. On July, 13, 1992, she presented with pulsating hemorrhage from the urinary bladder. Angiography was consistent with rupture into the bladder of an iliac artery aneurysm. Surgical intervention for closure of the aneurysm was performed but the aneurysm could not be resected. She had relapse of the fistula which became infected with methicillin-resistant Staphylococcus aureus (MR-SA), and died 3 months postoperatively. To the best of our knowledge, there have been only 3 cases in which an iliac artery aneurysm ruptured directly into the urinary bladder. This case indicates that resection of the aneurysm for therapy is a vital requirement.
本文报告一例因髂外动脉瘤破裂至膀胱导致致命性出血的病例。患者为一名58岁的日本女性，1974年因子宫癌接受了全子宫切除术及术后放射治疗。1992年5月发现膀胱结肠瘘，并进行了闭合手术干预。1992年7月13日，她出现膀胱搏动性出血。血管造影显示与髂动脉瘤破裂至膀胱相符。进行了闭合动脉瘤的手术干预，但无法切除动脉瘤。她的瘘管复发并感染了耐甲氧西林金黄色葡萄球菌（MR-SA），术后3个月死亡。据我们所知，仅有3例髂动脉瘤直接破裂至膀胱的病例。该病例表明，切除动脉瘤进行治疗是至关重要的。
