Case Report of Spontaneous Rupture of the Inferior Vena Cava Associated with Infrarenal Abdominal Aortic Aneurysm / 日本心臓血管外科学会雑誌

ABSTRACT

Spontaneous formation of aorto-caval fistulae is rare, occurring only in 4% of all ruptured abdominal aneurysms, and spontaneous rupture of the inferior vena cava (IVC) associated with the unruptured abdominal aneurysm has not been previously found in the literature. A 79-year-old woman with abdominal pain and hemorrhagic shock, was found to have a leaking abdominal aortic aneurysm and was transferred to our hospital. Preoperative CT revealed a massive right retroperitoneal hematoma and an infrarenal large abdominal aortic aneurysm. At laparotomy, no leaking site was found in the aneurysm, but a 2-cm laceration in the wall of IVC was found. The injured site was closed with a patch while controlling bleeding with a balloon catheter. The patient recovered uneventfully and was discharged on the 17th postoperative day. The mechanism of spontaneous rupture of the IVC is unknown, but and may occur due to incidental and abrupt increase in venous pressure in a stenotic IVC.