A case of surgical resection of a ruptured azygos vein aneurysm

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  • Mitsumata Shohei
    Department of General Thoracic, Breast and Endocrine, and Pediatric Surgery, Fukuoka University School of Medicine Department of Thoracic Surgery, National Hospital Organization Omuta National Hospital
  • Ueda Yuichiro
    Department of General Thoracic, Breast and Endocrine, and Pediatric Surgery, Fukuoka University School of Medicine
  • Shiraishi Takeshi
    Department of General Thoracic, Breast and Endocrine, and Pediatric Surgery, Fukuoka University School of Medicine
  • Sato Toshihiko
    Department of General Thoracic, Breast and Endocrine, and Pediatric Surgery, Fukuoka University School of Medicine

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  • 破裂奇静脈瘤に対し外科的切除を施行した一例

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Abstract

<p>A 53-year-old man presented to a previous hospital for evaluation of a 1-month history of back pain. Contrast-enhanced computed tomography revealed a 3.5-cm azygos vein aneurysm (AVA) and massive pleural effusion, suggestive of AVA rupture. The patient was referred to our hospital on the same day and underwent emergency AVA resection.</p><p>A massive hematoma and bleeding from the aneurysm were confirmed in the thoracic cavity. Thoracotomy was performed because it was difficult to stop the bleeding. The patient's postoperative course was uneventful, and he was discharged 8 days postoperatively.</p><p>AVAs are extremely rare, and indications for surgical resection remain unclear. AVAs have risks of thromboembolism and rupture. Aneurysm enlargement, saccular structure, and a history of connective tissue disease have been reported as risk factors of rupture. The saccular structure of the aneurysm might have been a risk factor in our case. In the case of AVA rupture, bleeding control is difficult; therefore, surgical resection is recommended to avoid aneurysm rupture even if there are no signs of thromboembolism or rupture.</p>

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