| Spontaneous Rupture of the Abdominal
Aorta in a Young Adolescent |
(Department of Cardiovascular Surgery and Emergency
and Critical Care Medical Center*, Niigata City General Hospital,
Niigata, Japan)
| Yuko Tosaka |
Hiroshi Kanazawa |
Yoshiki Takahashi |
| Satoshi Nakazawa |
Yoshihiko Yamazaki* |
|
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We describe a young adolescent patient
with spontaneous abdominal aortic rupture who was treated successfully.
A 14-year-old boy was admitted to our hospital with severe abdominal
pain and hypovolemic shock, without any episode of trauma. Computed
tomography (CT) revealed massive hematoma in the retroperitoneal
space and extravasation of copious amounts of contrast medium
in front of the terminal aorta. Neither aortic aneurysm nor dissection
was observed in this CT. An emergency operation was carried out.
At first, left thoracotomy and clamping of the thoracic descending
aorta were performed in order to reduce the aortic bleeding.
Midline laparotomy revealed an aortic perforation of approximately
8mm at the bifurcation of the abdominal aorta. The aortic wall
surrounding the perforation was nearly normal without any aortic
aneurysm or dissection. A segment of the terminal aorta (length,
3cm) including the perforated lesion was excised and reconstruction
was performed with a woven Dacron tube graft (10mm in diameter).
On microscopic examination, the marginal tissue near the perforation
showed diminished elastic fibers and minimal dissection of the
medial layer of the aortic wall; however, no cystic medial necrosis
or inflammation was seen.
Jpn. J. Cardiovasc. Surg. 33: 57 -60 (2004) |
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