| A Case of Ruptured Abdominal
Aortic Aneurysm Associated with Postoperative Paraplegia |
(Department of Cardiovascular Surgery, Nagano Red
Cross Hospital, Nagano, Japan)
| Masayuki Sakaguchi |
Naobumi Fujii |
Kazunori Nishimura |
| Nobuyuki Yanagiya |
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A 72-year-old woman complaining
of lumbago was transferred to our hospital in a state of shock.
An admission abdominal CT scan showed infrarenal aortic aneurysm
reaching 8cm in maximal diameter and hematoma of the retroperitoneal
space. A clinical diagnosis of ruptured abdominal aortic aneurysm
was rapidly established. An emergency operation was performed
under general anesthesia. Laparotomy disclosed an infrarenal
abdominal aortic aneurysm and hematoma. The aorta was clamped
just below the bilateral renal arteries. Straight graft replacement
was performed. There was enough heparinization during the surgical
procedure. Postoperative findings involved paraplegia and hypoesthesia
from dermatome Th10 with associated urinary and fecal incontinence.
The patient was discharged from our hospital. Spinal cord ischemia
is a rare and unpredictable complication in surgery of infrarenal
abdominal aortic aneurysms. Presence of intra- and postoperative
episodes of hypotension and the duration of the crossclamping
seem to have been the most important factors for spinal cord
ischemia in this case.
Jpn. J. Cardiovasc. Surg. 30: 146-148 (2001) |
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