ABSTRACT
A 66-year-old man had presented with nausea and vomiting at a neighboring hospital. Abdominal CT scan revealed a giant aortic abdominal aneurysm accompanied by duodenal obstruction. Y-graft replacement operation was performed in our hospital. Although aortic abdominal aneurysm is often unexpectedly diagnosed by abdominal CT scan, very few cases of aortic abdominal aneurysm have been diagnosed in association with ileac abdominal symptoms; for example vomiting and abdominal pain. We report a case of giant aortic abdominal aneurysm with symptoms of duodenal obstruction, describing pathophysiologic aspects.
ABSTRACT
Plasma concentrations of tumor necrosis factor α (TNFα), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were measured successively during and after open heart surgery (13 cases). Plasma concentrations of TNFα did not increase during surgery but increased gradually after the 1st operative day reached the maximum level at the 7th operative day (128±15pg/ml, which was a 3-fold increase compared with the previous value). Plasma concentrations of IL-1β remained at the previous level during surgery and increased only once at 6 hours after operation. Conversely, plasma concentrations of IL-6 increased dramatically during cardiopulmonary bypass (CPB) reaching a peak at the end of CPB (260±200pg/ml, which was a 15-fold increase over the previous value) and recovered to previous values rapidly thereafter. Plasma IL-6 concentrations changed rapidly during surgery, while plasma concentrations of TNFα and IL-1β did not increase sharply. This may indicate that IL-6 may play a role as a mediator of acute inflammatory reaction.