A case of sigmoid colon cancer with severe stricture associated with an iliac arterial aneurysm at a high risk of rupturing

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  • 破裂危険のある内腸骨動脈瘤を合併した高度狭窄を伴うS状結腸癌の1例
  • 症例 破裂危険のある内腸骨動脈瘤を合併した高度狭窄を伴うS状結腸癌の1例
  • ショウレイ ハレツ キケン ノ アル ナイ チョウコツ ドウミャクリュウ オ ガッペイ シタ コウド キョウサク オ トモナウ Sジョウ ケッチョウ ガン ノ 1レイ

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We often encounter the coexistence of colorectal cancer and an iliac arterial aneurysm. When each disease requires each emergency treatment, we have often difficulties in deciding that either treatment should precede the other. We present our experience with a case of sigmoid colon cancer with severe stricture associated with an iliac arterial aneurysm at a high risk of rupturing, in which we performed endovascular aneurysm repair flowed by sigmoidectomy. The case involved an 81-year-old man diagnosed with sigmoid colon cancer with severe stricture by colonoscopy. Furthermore, abdominal CT scan performed before operation revealed a 60-mm diameter right iliac arterial aneurysm. Both lesions needed emergency treatments, but we determined that the risk of rupturing of the iliac arterial aneurysm was higher than the other. Endovascular aneurysm repair was performed, followed by sigmoidectomy, on the 22nd postoperative day. The postoperative course was uneventful and the patient was discharged from the hospital on the 19th day after the second operation.<BR>In the treatment of colorectal cancer associated with an iliac arterial aneurysm, the approach like ours in which surgery for colorectal neoplasm was preceded by endovascular aneurysm repair appears useful in terms of surgical invasion, shortening of therapy time, and the safety.

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