Key result
Emergency tube graft replacement rescues a 95-year-old man with ruptured iliac aneurysm and cardiac arrest.
Case Report (n=1)
No
Emergency prosthetic graft replacement can be life-saving and lead to functional recovery even in nonagenarians with ruptured common iliac artery aneurysm and cardiopulmonary arrest.
Emergency repair may be feasible in select nonagenarians with ruptured iliac aneurysm and arrest; leaves open generalizability beyond this single case.
症例は95歳男性．朝7時ごろから繰り返す意識消失を主訴に17時ごろ前医を受診した．造影CTにて左後腹膜に巨大な血腫を伴う腹部大動脈破裂と診断され当院救急搬送となった．前医出発直前に心肺停止（cardiopulmonary arrest［CPA］）となり無脈性電気活動（pulseless electrical activity［PEA］）の状態で緊急手術を開始した．全腹部正中切開で開腹したところ左総腸骨動脈瘤破裂であった．腹部大動脈中枢側を遮断，自己心拍での循環動態の改善を確認し可及的速やかに人工血管置換術を行った．閉腹の際に腸管の浮腫が著明でありイレウス管を使用して腹腔内の減圧を行った．術後5日目まで人工呼吸管理を要したがその後は経過良好でリハビリ施行により自立歩行も可能な状態となり，術後28日目に他院へ転院した．
No takes yet. Share an insight, caveat, or question.
Kawai et al. (2009) conducted a case report in Ruptured common iliac artery aneurysm with cardiopulmonary arrest (n=1). Emergency surgery (replacement of the left common iliac artery with a tube graft) was evaluated on Survival and recovery. A 95-year-old man with a ruptured common iliac artery aneurysm and cardiopulmonary arrest was successfully resuscitated and treated with emergency tube graft replacement, surviving to discharge.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: