Makoto Funami

Spontaneous rupture of the iliac vein: report of a case

We reprot a rare case of a spontaneous rupture of the iliac vein which was then surgically treated with good results. A 66-year-old woman was admitted complaining of leg swelling and lower abdominal pain. On the 3rd day after admission, an operation was performed because of a gradually increasing hematoma in the retroperitoneal space. Laparotomy revealed a 17 mm longitudinal tear on the anterior surface of the left external iliac vein with a thrombus inside the lumen. Most of the previously reported 14 cases of this nature have required emergency operations.

The retroperitoneal approach to aortoiliac surgery associated with a horseshoe kidney: report of a case.

The presence of a horseshoe kidney associated with aortoiliac vascular disease poses technical difficulties in terms of vascular reconstruction. The renal isthmus, position of the renal pelvis and ureters, and variable blood supply to the horseshoe kidney can complicate aortoiliac reconstruction. The left retroperitoneal approach provides excellent exposure of the abdominal aorta in patients with a horseshoe kidney without dividing the renal isthmus and avoids the risk of injury to a ureter in an anomalous position. We herein report the case of a patient with a horseshoe kidney who underwent a successful reconstruction of aortoiliac vascular disease using the left retroperitoneal approach.

A Case of Impending Ruptured Aneurysm of the Common Iliac Artery; Regarded as Being Associated with Serous Leakage in Retroperitoneal Space.

後腹膜腔にゼラチン様物質の貯留を伴った, 動脈瘤切迫破裂の一例を経験した. 症例は69歳, 男性. 左下腹部の膨満感と軽い疼痛があり, CTにて左総腸骨動脈瘤を認めた. 5日後, 急激な疼痛の増強がみられたため再度CTを施行し, 左後腹膜腔の low density mass を認めた. 緊急手術によりY型人工血管移植術を施行した. 手術時, 左後腹膜腔に約600cm3の無色透明ゼラチン様物質の貯留を認めたが瘤破裂の所見はなかった. 術後42日目のCTでは low density mass は消失していた. ゼラチン様物質の電解質は, Na+ 115.8mEq/l, K+ 6.11mEq/l, Cl- 102.6mEq/lであり, 瘤壁を通じ血漿成分が後腹膜腔へ漏出貯留したものである, と推論した. きわめて特殊な症例であると判断したので, ここに報告する.