Isolated rupture of aneurysm of the internal iliac artery

Isolated aneurysms of the internal iliac artery are rare and often asymptomatic. They are frequently diagnosed as a result of complications such as rupture. The authors describe in detail two cases of ruptured aneurysms of the internal iliac artery treated by emergency surgery with no perioperative mortality or morbidity.     

Delayed rupture of an internal iliac artery aneurysm following proximal ligation for abdominal aortic aneurysm repair

This is a report of a patient presenting with a contained rupture of an internal iliac aneurysm following proximal ligation after abdominal aortic aneurysm repair three years earlier. The patient presented with a large pelvic mass with symptoms of urgency, frequency, dysuria, tenesmus and fevers associated with anemia. Following evacuation of the aneurysm and direct suture ligation of the distal branches of the internal iliac artery, the patient's aortic graft was covered with omentum which also filled the pelvic cavity. The importance of proximal and distal control of aneurysms and/or the importance of complete luminal control of internal iliac artery aneurysms is emphasized by this case.     

腹主动脉瘤腔内治疗术后主髂动脉破裂的治疗

背景与目的:腹主动脉瘤(AAA)腔内治疗术(EVAR)的发展和推广使患者的寿命显著延长,也伴随越来越多的术后远期并发症发生,其中最严重的就是术后主髂动脉继续扩张最终破裂,病情凶险、治疗难度大.本文通过回顾性分析本中心收治的EVAR术后主髂动脉破裂的病例,探讨、总结该疾病的治疗策略.方法:回顾性分析2016年6月-202...     

Spontaneous mycotic external iliac artery aneurysm rupture after perforated acute appendicitis in a renal allograft recipient

Acute appendicitis is uncommon after renal transplant. Infection with Candida albicans can produce serious complications by compromising the vascular anastomosis. In such cases, the origin of Candida albicans is often in the gastrointestinal system. Here, we report 2 uncommon complications that occurred in the same patient. A 27-year-old female renal transplant patient with appendicitis presented to our institution with acute graft failure. The patient was treated with an appendectomy and a transplant nephrectomy. Subsequently, the patient had a mycotic pseudoaneurysm rupture of the external iliac artery secondary to Candida albicans infection that originated possibly in the gastrointestinal system. This complication was further treated with a cross-femoral bypass. The occurrence of these 2 complications together is rare.     

Unilateral lower extremity paralysis after coil embolization of an internal iliac artery aneurysm

Neurologic complications after treatment of internal iliac artery (IIA) aneurysms are rare, especially if confined to one IIA. We report a patient in whom profound right lower extremity paresis developed after unilateral right IIA coil embolization for treatment of a 4-cm IIA aneurysm, despite the presence of a patent contralateral IIA. This case illustrates the important, yet unpredictable, nature of pelvic blood flow to the distal spinal cord and lumbosacral plexus and the unpredictable consequence of IIA occlusion.     

Isolated iliac artery aneurysm rupture presenting as left iliac fossa pain and diarrhoea: A case report

Isolated iliac aneurysm rupture is rare and difficult to diagnose, but needs to be actively considered and excluded. We document the case of a 71 year old female who presented with left iliac fossa pain and diarrhoea and was subsequently found to have a ruptured isolated iliac artery aneurysm. This case demonstrates the importance of urgent diagnostic CT in surgical patients, who present with features of abdominal pain and shock. The key to survival is early diagnosis, appropriate resuscitation and prompt definitive open or endovascular repair.     

Splenic artery aneurysm rupture

This is the report of a case with an atherosclerotic splenic artery aneurysm ruptured into the peritoneal cavity which presented with hypovolaemic shock. The patient underwent successfully emergency laparotomy and splenectomy. A brief review of the the literature follows.     

Massive hematuria after cystoscopy in a patient with an internal iliac artery aneurysm.

An unusual case is reported here of a patient with internal iliac artery aneurysm who developed massive hematuria after cystoscopic examination. A 75-year-old man presented with asymptomatic gross hematuria. Cystoscopic examination revealed that the bladder neck was congested and that the right-side wall was being pressed on by an extrinsic mass. Computed tomography showed a right internal iliac artery aneurysm and tortuous perivesical vessels. Three days after the cystoscopic examination the patient suffered massive hematuria. Hemorrhage due to an arteriovesical or arterio-ureteral fistula secondary to rupture of the internal iliac artery aneurysm was suspected, and an emergency operation was performed. At operation the aneurysm had not ruptured but overswelling perivesical vessels were found to have developed, and these fed a high blood flow to the bladder neck. In the present case cystoscopic examination injured the mucosa and led to massive hemorrhage from the bladder neck.     

Splenic artery aneurysm rupture

BACKGROUND: Splenic artery aneurysms are uncommon even though they are second only to those of the aorto-iliac system. There is also controversy regarding their management. METHODS: We report the case of a 50-year-old patient with ruptured splenic artery aneurysm and review the literature regarding its diagnosis and management. RESULTS: The patient underwent emergency laparotomy and splenectomy was performed. CONCLUSION: Resuscitation and an aggressive surgical approach should be taken in order to save the life of the patients.     

Visceral artery aneurysm rupture

PURPOSE: Aneurysms of the visceral arteries are infrequently encountered. Many are found incidentally and are thought to have a benign outcome. To better characterize these lesions and their clinical course, we reviewed our experience with visceral artery aneurysms (VAAs) at a single institution. METHODS: A retrospective analysis of all VAAs diagnosed at our institution over the past 10 years was performed. The presentation, management, and outcome of therapy was examined for each patient. RESULTS: Thirty-four VAAs in 26 patients were diagnosed over the past 10 years. Four patients had multiple VAAs: splenic (17), hepatic (7), celiac (3), superior mesenteric (2), gastroduodenal (2), pancreaticoduodenal (1), right gastric (1), ileal (1) artery aneurysms. Associated aneurysms were found in 31% of patients and involved the thoracic aorta (3 patients), abdominal aorta (4 patients), renal arteries (2 patients), iliac artery (3 patients), lower extremity (1 patient), and intracranium (1 patient). In 15 patients (58%), VAAs were detected before rupture by chance or because abdominal symptoms resulted in diagnostic evaluation. Eight of these underwent elective surgery, and there were no deaths. Of those 15 patients with known VAAs, one patient died of rupture and hemorrhage from an untreated splenic artery aneurysm. Eleven patients (42%) presented unexpectedly with rupture, and two died despite prompt surgical treatment. The mortality rate in patients who had ruptured VAAs was 25%, including those who presented with ruptured aneurysms and those observed whose aneurysms eventually ruptured. CONCLUSIONS: Aneurysms of the visceral arteries are rare but important vascular lesions. Associated aneurysms are common. Because of the risk of rupture, often with a fatal outcome, an aggressive approach to the treatment of VAA is essential.