Surgical Rescue in a Case Involving a Ruptured Delayed Pseudoaneurysm of the Mesenteric Artery following Blunt Abdominal Trauma Caused by a Road Traffic Accident

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  • 交通外傷後遅発性に発症し救命した外傷性腸間膜仮性動脈瘤破裂の1例
  • 症例 交通外傷後遅発性に発症し救命した外傷性腸間膜仮性動脈瘤破裂の1例
  • ショウレイ コウツウ ガイショウ ゴチハツセイ ニ ハッショウ シ キュウメイ シタ ガイショウセイ チョウ カンマク カセイ ドウミャクリュウ ハレツ ノ 1レイ

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Abstract

A 38-year-old man accidentally crashed while driving a car one morning. He was observed at home because there were no apparent symptoms immediately after the accident. Later that evening, he visited our hospital because of the onset of abdominal pain. Using computed tomography (CT), we diagnosed the patient as having experienced a traumatic mesenteric injury adjacent to the sigmoid colon. Although he showed temporary improvement with conservative therapy following admission, his condition changed on the 17th day of hospitalization. An abdominal CT scan revealed a ruptured delayed pseudoaneurysm of the mesenteric artery, and we performed surgery on the same day. Intraoperative findings revealed a ruptured delayed pseudoaneurysm of the left colic artery and perforation of the sigmoid colon. We performed a Hartmann operation (partial sigmoidectomy and colostomy). The patient's clinical course was positive and he was discharged to his home on the 33rd day after surgery. Trauma physicians should consider this case when treating patients who have experienced blunt abdominal trauma.

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