Vasc Spec Int.  2014 Jun;30(2):76-79. 10.5758/vsi.2014.30.2.76.

Open Repair of Ruptured Huge Aorto-Iliac Aneurysm: Warning of Colon Ischemia

Affiliations
  • 1Division of Transplantation and Vascular Surgery, Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea. shuh@knu.ac.kr

Abstract

A giant abdominal aortic aneurysm (AAA) renders surgical treatment much more difficult by deforming the proximal infrarenal aortic neck (shortened length and disturbed angulation), by altering the iliac arteries (marked tortuosity and aneurysmal dilatation), and by displacing abdominal organs. Because the retroperitoneal rupture of giant AAA makes the mesentery more elongated and deformed, compromising its blood flow and thus increasing the risk of mesenteric ischemia such as colon ischemia. We describe here the surgical repair of a large infrarenal AAA with a ruptured huge left common iliac artery aneurysm of 13.5 cm in diameter, accompanied by colostomy due to colon ischemia which occurred during the operation. We discuss the pathophysiology and preventive strategy of colon ischemia during ruptured giant AAA repair.

Keyword

Abdominal aortic aneurysms; Ruptured aneurysm; Ischemic colitis

MeSH Terms

Aneurysm*
Aneurysm, Ruptured
Aortic Aneurysm, Abdominal
Colitis, Ischemic
Colon*
Colostomy
Iliac Artery
Ischemia*
Mesentery
Neck
Rupture
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