Résumé
A 70-year-old man was admitted with upper abdominal pain. Endoscopic examination demonstrated early gastric cancer, which computed tomography and ultrasonography showed a 6cm infrarenal abdominal aortic aneurysm and bilateral common iliac artery aneurysms. The patient underwent distal gastrectomy, then 33 days later repair of the abdominal aortic aneurysm and bilateral common iliac artery aneurysms with a Dacron graft via a retroperitoneal approach. The patient had a good postoperative course. There have been many reports on the management of combined gastrointestinal malignancy with abdominal aortic aneurysm. We recommend two-stage operation except in patients at high risk of cardiac or pulmonary complications because of the minimum risk of graft infection, and consider that a retroperitoneal approach is good for aortic surgery in cases with a history of previous transabdominal operations.
Résumé
Vascular trauma of the upper extremities is rare. We have successfully treated a case of laceration of the right subclavian artery induced by chest injury. A 45-year-old man with blunt trauma was admitted and angiography revealed laceration of the right subclavian artery. The injured area was exposed by a median sternal approach. The right common carotid-subclavian artery bypass was successfully performed with autogenous vein graft in less than three hours from admission. He recovered without any neurological deficit or functional disability and returned to his former occupation.