Case: A 92-year-old woman was emergently admitted to our hospital for peritonitis caused by sigmoid colon cancer perforation, with a coexistent abdominal aortic aneurysm of 76 mm in diameter. Outcome: A 92-year-old woman was admitted to the hospital with a complaint of abdominal pain and fever of 24-h duration. On physical examination, severe tenderness with muscular defense and a palpable, pulsating mass were detected in the upper abdomen. The patient was diagnosed as having panperitonitis caused by sigmoid colon perforation. Computed tomography also revealed an infrarenal abdominal aortic aneurysm of 76 mm in diameter. We performed endovascular aneurysm repair to prevent aneurysmal rupture in the perioperative period and simultaneously performed intra-abdominal drainage and Hartmann's operation. The patient's postoperative course was uneventful. Conclusion: Simultaneous endovascular aneurysm repair and operation for peritonitis is considered a possible treatment strategy for patients at high risk of abdominal aortic aneurysm rupture.
Case: A 92-year-old woman was emergently admitted to our hospital for peritonitis caused by sigmoid colon cancer perforation, with a coexistent abdominal aortic aneurysm of 76 mm in diameter. Outcome: A 92-year-old woman was admitted to the hospital with a complaint of abdominal pain and fever of 24-h duration. On physical examination, severe tenderness with muscular defense and a palpable, pulsating mass were detected in the upper abdomen. The patient was diagnosed as having panperitonitis caused by sigmoid colon perforation. Computed tomography also revealed an infrarenal abdominal aortic aneurysm of 76 mm in diameter. We performed endovascular aneurysm repair to prevent aneurysmal rupture in the perioperative period and simultaneously performed intra-abdominal drainage and Hartmann's operation. The patient's postoperative course was uneventful. Conclusion: Simultaneous endovascular aneurysm repair and operation for peritonitis is considered a possible treatment strategy for patients at high risk of abdominal aortic aneurysm rupture.
Authors: Monique Prinssen; Eric L G Verhoeven; Jaap Buth; Philippe W M Cuypers; Marc R H M van Sambeek; Ron Balm; Erik Buskens; Diederick E Grobbee; Jan D Blankensteijn Journal: N Engl J Med Date: 2004-10-14 Impact factor: 91.245