Traumatic Aortic and Celiac Pseudoaneurysm with Aortocaval Fistula Managed with Endovascular Aortic Cuff Deployment and Open Hepatic Revascularization
| Autor: | Matthew Schneck, Bernadette J. Goudreau, Carlin Williams, Ankur Aggarwal, Margaret Tracci Jd, Thomas J. Gianis, J. Fritz Angle |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Aorta Common hepatic artery business.industry medicine.medical_treatment Arteriotomy General Medicine Revascularization medicine.disease Surgery Pseudoaneurysm Celiac artery Splenic vein medicine.artery Laparotomy cardiovascular system medicine Cardiology and Cardiovascular Medicine business |
| Zdroj: | Annals of Vascular Surgery. 73:508.e1-508.e6 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2020.10.036 |
| Popis: | We present the case of a young patient who sustained a gunshot wound to the abdomen initially treated with laparotomy and repair of small bowel, splenic vein and diaphragmatic injuries. Subsequent computed tomography (CT) performed for hemodynamic instability demonstrated a pseudoaneurysm involving the aorta and proximal celiac artery, with an associated aortocaval fistula. An attempt at transperitoneal repair of these injuries was aborted due to extensive inflammatory changes in the region encountered during exposure. Subsequently, a hybrid repair was performed. This consisted of exclusion of the aortic and celiac artery pseudoaneurysm using an endovascular aortic cuff (22 × 39 mm, Cook Medical) via infrarenal aortic access, surgical ligation of the celiac artery branches, and revascularization via bypass from the infrarenal aortic access site arteriotomy to the common hepatic artery. |
| Databáze: | OpenAIRE |
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