| Surgical Treatment of a Patient
with Aorto-pulmonary Fistula due to Thoracic Aortic Aneurysm
Rupture Associated with Gastric Carcinoma |
(Second Department of Surgery, Yamanashi Medical
University, Yamanashi, Japan)
| Shinya Motohashi |
Shunya Shindo |
Kenji Kubota |
| Atsuo Kojima |
Tadao Ishimoto |
Keiji Iyori |
| Masahiro Kobayashi |
Yusuke Tada |
|
|
A 57-year-old man suffered hemoptysis
during an examination for gastric carcinoma. Enhanced computed
tomography demonstrated rupture of a thoracic aortic aneurysm
to the left pulmonary lower lobe. The lateral segment of the
liver was atrophic due to intrahepatic cholelithiasis. Emergency
operation was performed after he was transferred to our hospital.
The thoracic aorta was reconstructed using a temporary bypass
and the pulmonary left lower lobe was resected. The omentum was
mobilized and used to cover the prosthesis and bronchial stump.
The gastric carcinoma and intrahepatic cholelithiasis with biliary
stones in the common bile duct were treated in the next procedure.
The pathologic examination revealed lymph node metastasis; thus
this operation was recognized to be absolutely noncurative. The
treatment of cardiovascular disease concomitant with malignancy
remains controversial. The strategy to treat such patients is
discussed in this report.
Jpn. J. Cardiovasc. Surg. 30: 265-267 (2001) |
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