A CASE OF INFLAMMATORY ANEURYSM OF ABDOMINAL AORTA COMPLICATED BY SEGMENTAL ISCHEMIA OF THE SIGMOID COLON

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We experienced a case of inflammatory aneurysm of the abdominal aorta which developed segmental ischemia of the sigmoid colon during the dissection of the aneurysm. We present here one of the ways how to manage such a complication. A 56-year-old man with an inflammatory aneurysm presented with abdominal pain, anorexia and body weight loss. The aneurysm was 10×8 cm, arising just below the renal arteries and extending to the bifurcation and the left common iliac artery. Inflammatory change of the aneurysmal wall was extensive and adherence to the adjacent structures was severe. During the dissection of the aneurysm segmental ischemia of the sigmoid colon developed. Sigmoid colon was exteriolized at the left lower part of the abdomen. Six days later loop colostomy was completed by resecting the necrotic segment and six months later colostomy was closed uneventfully. The patient has been well with no episode of abdominal pain during three and a half years of follow-up, gaining 10 kg of body weight and showing no signs of graft infection.
日本臨床外科学会の論文