Résumé
Concomitant occurrence of acute aortic dissection and atherosclerotic aneurysm is rare. In such a circumstance, rupture of the existing aneurysm is the more likely scenario. In general, atherosclerotic plaque frequently serves to terminate the dissection process. A 65-year-old man with an abdominal aortic aneurysm was admitted due to severe back pain. Emergency CT showed acute aortic dissection (Stanford B) with a partially thrombosed pseudo-lumen and fusiform abdominal aortic aneurysm. Hemolysis occurred due to compression of the true lumen by the thrombosed pseudo-lumen. Emergency abdominal aortic graft replacement was performed successfully.
Résumé
We report a case who received a combined operation for abdominal aortic aneurysm (AAA) and colon carcinoma. The AAA was 7cm in diameter and the colon carcinoma was advanced without distant metastasis. To prevent contamination in the operative field, a temporary stoma was chosen instead of anastomosis for the partial colon resection. Since the patient suffered severe coronary three-vessel disease, we applied the same management as for cardiac surgery during the operation and postoperatively. There were no complications such as myocardial infarction. We assume that the number of patients with AAA complicated with malignant tumor or ischemic heart disease may increase in future. It is necessary to be careful and perform further investigations concerning operation method and perioperative management.