| Autor: |
Sakamoto, Kazuhiko, Tokuhisa, Akihiro, Nishimura, Kenyu, Tokunou, Kazuhisa, Kamei, Ryoji, Kitamura, Yoshinori, Ando, Seiichiro, Yamamoto, Tatsuhito, Sato, Masafumi, Kobayashi, Toshiro, Gohra, Hidenori |
| Zdroj: |
International Journal of Surgery Case Reports; 2018, Vol. 51, p190-193, 4p |
| Abstrakt: |
Highlights • The soft tissue mass at the stump of artery suspected of pseusdoaneurysm. • Embolization and artery bypass are effective for pseudoaneurysm of the iliac artery. • Prophylactic arterial flow block may be safe to avoid recurrence of pseudoaneurysm. Abstract Introduction An optimal treatment strategy for a ruptured pseudoaneurysm of the iliac artery must necessarily control bleeding and prevent ischemia in the ipsilateral lower extremity. Presentation of case A 69-year-old man underwent resection of a metastatic lymph node from rectal cancer, which had invaded the sigmoid colon, the left internal iliac artery and vein, and his left ureter. The metastatic lymph node and the organs it invaded were resected together. Owing to postoperative complications, the patient was required to undergo a 2nd and 3rd operation after the initial surgery. During his 3rd surgery, sudden intraoperative bleeding was identified, which was diagnosed as a ruptured pseudoaneurysm of the internal iliac artery. After achieving temporary surgical hemostasis, the lesion was successfully treated using combined therapy comprising catheter embolization and an axillofemoral bypass. Discussion Even after temporary surgical hemostasis has been achieved, it is perhaps safer to block the arterial flow prophylactically to avoid recurrence of a pseudoaneurysm owing to infection. Conclusion Combined therapy using catheter embolization and surgical revascularization is a minimally invasive and effective treatment option for a ruptured pseudoaneurysm of the iliac artery. [ABSTRACT FROM AUTHOR] |
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