症例報告

著者

塚本三重生　　折目由紀彦　　長　　伸介　　根岸　七雄*
駿河台日本大学病院心臓血管外科
*日本大学医学部外科学講座心臓血管外科部門

要旨

We report the case of an isolated internal iliac artery aneurysm that ruptured into the peritoneal cavity without retroperitonealhematoma. A preoperative CT scan revealed hemoperitoneum, although no retroperitoneal hematoma was detected.Intraoperatively, the neck of the saccular right internal iliac artery aneurysm was found to be split. The patient hadfallen from a platform several weeks earlier and we presumed that the retroperitoneum was fissured due to a strongtraction force that occurred during the fall. While the inferior mesenteric artery was preserved, a bifurcated prosthesis wasimplanted and the bilateral internal arteries were closed with suture ligation (endoaneurysmorrhaphy). Postoperative CTexamination showed a good result. Ruptured iliac artery aneurysm is usually followed by retroperitoneal hematoma. Inthis case, however, we presumed that the aneurysm was already connected to the peritoneal cavity when he fell from theplatform, causing the aneurysm to rupture.

keyword

internal iliac artery aneurysm, ruptured aneurysm
孤立性腸骨動脈瘤，動脈瘤破裂