| Different Outcomes in Two Cases with Ruptured Pseudoaneurysms |
| 가성동맥류 파열환자에서 치료 시점에 따른 상이한 임상 결과 2예 |
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이대상*ㆍ박치민*,† |
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Departments of *Critical Care Medicine and †Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
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| Abstract |
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Rupture of pseudoaneurysm is a rare but serious complication after intra-abdominal surgery. A 58-year-old male patient with early gastric cancer underwent a laparoscopy-assisted distal gastrectomy. On the 31th postoperative-day (POD) he presented melena. An angiography demonstrated a splenic artery pseudoaneurysm. After angiographic embolization, the patient developed hemorrhagic shock and an urgent laparotomy was carried out. The laparotomy revealed bleeding of splanchnic artery. A 68-year-old male with common bile duct cancer underwent Roux-en-Y hepaticojejunostomy. On the 26th POD he visited our emergency department by melena for four days. Computed tomography showed 23 mm hepatic artery pseudoaneurysm. An angiography wasn't arranged immediately but arranged after hypovolemic shock. After stent graft, the laparotomy was undergone to reduce an intra-abdominal hypertension and to control bleeding. The patient at the right time treatment was survived but later one was dead because of delayed decision and treatment. Bleeding control and adequate fluid resuscitation at the right time are essential in the rupture of pseudoaneurysm. (J Acute Care Surg 2013;3:63-68) |
| Key Words:
Aneurysm, Postoperative period, Hemorrhage, Resuscitation |
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