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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Massive hemorrhage of the upper part of the gastrointestinal tract presents a formidable crisis in surgical management. The preoperative diagnosis should be suspected in patients with a vascular prosthesis or primary abdominal aortic aneurysm. The characteristic signs and symptoms represent the triad of a pulsatile mass in the upper part of the abdomen, intermittent hemorrhage in the upper part of the gastrointestinal tract and severe epigastralgia not relieved by antacids. No ideal operative technique has evolved for correcting the abnormal physiopathologic condition. Our recent experience with three patients highlights the problems of unremitting sepsis and recurrent fistulization.
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PMID:Treatment of massive gastrointestinal hemorrhage from aortoenteric fistula. 30 14

The clinical courses of three cases with various alimentary tract malignant lesions coincidental with abdominal aortic aneurysm were reported. Of those three patients, a simultaneous resection of the malignant lesion and aneurysm was carried out in two patients, while an secondary abdominal aneurysmectomy following the resection of the malignant lesion was done in one patient. A 70-year-old man with cancer of the cecum and an infra-renal abdominal aneurysm, was diagnosed preoperatively, and a simultaneous right hemicolectomy and aneurysmectomy were carried out. In the other patient, a 77-year-old man, presence of the gastric cancer was incidentally found at laparotomy and a 75 percent gastrectomy and an aneurysmectomy were carried out. In the third patient, both gastric cancer and an abdominal aneurysm were detected preoperatively. Distal partial gastrectomy was performed first because of severe epigastralgia and an asymptomatic aneurysm. The abdominal aneurysmectomy was carried out six months later. All patients were treated by daily administration of Cefazolin sodium or cefalotin sodium (4-10 g) and Dibekacin sulfate (200 mg) for seven to ten days postoperatively. In the case of second look operation, however, Fosfomycin 2-4 g/day was added to the above mentioned drug following the aneurysmectomy. All tolerated surgery well without any signs of infections. The first patient died on the 57th postoperative day from panperitonitis carcinomatosa following an episode of intestinal obstruction. Selection of the operative approaches for patients having both an alimentary tract malignant tumor and an abdominal aortic aneurysm was difficult, although the initial surgical intervention for the more life threatening lesion would be better justified.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Surgical approach to abdominal aortic aneurysm with malignant alimentary tract tumor: report of three cases]. 374 94

An aged male with a known history of abdominal aortic aneurysm suffered from epigastralgia, vomiting and cold sweating for one day. According to the physical examination, serum amylase level and computed tomographic examination, acute pancreatitis was diagnosed. Surgical intervention for the abdominal aortic aneurysm was not performed because of his age, and finally this patient died after three recurrent episodes. Acute pancreatitis co-existing with an intact abdominal aortic aneurysm has never been reported before. The possible pathogenesis of this recurrent acute pancreatitis was discussed.
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PMID:Abdominal aortic aneurysm compression is probably responsible for the recurrent episodes of acute pancreatitis: case report. 1052 53

We performed successful simultaneous operations for an abdominal aortic aneurysm (AAA) and liver cancer in a patient complicated by severe ischemic heart disease. A 59-year-old man with a history of liver dysfunction presented with acute epigastric pain. Abdominal computed tomography findings of ascites and a liver tumor indicated a diagnosis of ruptured hepatocellular carcinoma. He had a concomitant 65-mm AAA and a 48-mm right common iliac aneurysm. Elective surgery was scheduled because of his good general condition. Although triple-vessel disease was detected preoperatively, there were no graftable coronary arteries. The aneurysms were repaired first to utilize intra-aortic balloon pumping (IABP) during resection of the liver cancer, followed by left lateral segmentectomy. Perioperative hemodynamics were maintained by administering catecholamines and vasodilators, without the need for IABP. The patient was discharged on the 21st postoperative day without any complications, and no recurrence of liver cancer has been found in the 5 months since his operation.
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PMID:Simultaneous operations for abdominal aortic aneurysm and liver cancer complicated by severe ischemic heart disease: report of a case. 1288

An association between autoimmune pancreatitis (AIP) and inflammatory abdominal aortic aneurysm (AAA) has never been reported. Reported herein is a case of IgG4-related inflammatory AAA accompanying metachronous AIP. A 77-year-old man presented with malaise and intermittent lower abdominal pain. Radiological examination showed inflammatory AAA and right hydronephrosis caused by retroperitoneal fibrosis. Surgical correction of the AAA was performed, but high levels of systemic inflammatory markers persisted. Four months after surgery, the patient presented with epigastric pain, backache, and jaundice. His serum IgG4 concentration was high (571 mg/mL), and he was diagnosed with AIP, based on clinical and radiological findings. Corticosteroid therapy resulted in improvement of the clinical findings and lowered his serum IgG4 levels. Subsequent histological examination of a specimen from the aortic wall showed irregular proliferation of fibroblastic and myofibroblastic cells, severe lymphoplasmacytic infiltration, and obliterative phlebitis in the adventitia. Furthermore, on immunohistochemistry many plasma cells within the lesion were found to be positive for IgG4. These findings suggest that inflammatory AAA has a pathological process similar to that of AIP, and that some cases of inflammatory AAA and retroperitoneal fibrosis may be aortic and periaortic lesions of an IgG4-related sclerosing disease.
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PMID:IgG4-related inflammatory abdominal aortic aneurysm associated with autoimmune pancreatitis. 1857 10

We report the case of a 61-year-old female who suffered from systemic lupus erythematosus (SLE) and died of a ruptured abdominal aortic aneurysm (AA). She was diagnosed to have SLE at 39 years of age, and was administrated steroids and prostaglandin E(2). From 52 years of age, AA, peripheral arterial occlusion, and multiple organ infarctions appeared repeatedly. At 59 years of age, she was found to be affected by antiphospholipid antibody syndrome (APS). In the following year, expansion of an abdominal AA was identified, but she was given only conservative treatment. In the next year, sudden epigastralgia and dyspnea occurred, and she died. An autopsy revealed multiple AAs up to 11 cm in diameter, one of which showed ruptures, forming a retroperitoneal hematoma. Marked atherosclerosis of the aorta was noted, and she also had aortic dissection accompanied by cystic medial necrosis (CMN). An old myocardial infarction and brain infarction were also confirmed. Although SLE with APS is common, a complication of the disease by CMN, multiple AAs, or ruptured AA has been described in several cases to date. Regarding the etiology of this complicated presentation, we presume synergistic involvement of various factors, such as atherosclerosis and CMN associated with SLE, thrombosis due to APS, and prolonged steroid therapy.
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PMID:Multiple aortic aneurysms complicated by a rupture in the systemic lupus erythematosus: a case report. 1865 88

A 55-year-old man developed hypertension and acute epigastric pain during dobutamine-atropine stress echocardiography (DASE). Evaluation-including a helical computed tomography (CT) scan of the abdomen and pelvis, as well as surgical exploration-revealed a ruptured splenic artery aneurysm. The patient died, despite multiple surgical interventions and a massive blood product transfusion. Impressively, no deaths from DASE have been previously reported. Additionally, no adverse sequelae during DASE have been reported in patients with an unruptured abdominal aortic aneurysm >or=4 cm in diameter or with an unruptured intracranial aneurysm. We report the first case, to our knowledge, of death caused by splenic artery aneurysm rupture during DASE. Splenic artery aneurysm rupture during DASE, though rare, can lead to death.
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PMID:Death caused by splenic artery aneurysm rupture during dobutamine-atropine stress echocardiography: case report and literature review. 1912 12

Splenic artery aneurysm is a rare but a potentially fatal condition. It is usually asymptomatic until it ruptures. Here, we present a case of ruptured splenic artery aneurysm in a 59-year-old gentleman presenting with epigastric pain and hypovolemic shock. The diagnosis was made by emergency ultrasound and CT scan, and he was managed by laparotomy and excision of the splenic artery aneurysm. Priorities in patient management lie in rapid resuscitation, diagnostic imaging, surgical consultation, and subsequent laparotomy. Pitfalls should be borne in mind to differentiate splenic artery aneurysm from abdominal aortic aneurysm when using the emergency ultrasound.
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PMID:Ruptured splenic artery aneurysm detected by emergency ultrasound-a case report. 2606 53