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KMID : 0371319700120040071
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Journal of the Korean Surgical Society
1970 Volume.12 No. 4 p.71 ~ p.74
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Ligtion of the Left Common Iliac Artery for Ruptured pseudoaneurysm
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이학용/Yi, Hak Yong
박영관/박성태/이기주/표창현/Park, Young Kwan/Park, Sung Tai/Yi, Kee Joo/Pyo, Chang Hyon
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Abstract
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Immediate reconstructive surgery following main arterial injury is generally treatment of choice. If "Time-Lag" is more than eight hours, the peripheral muscles often developed ischemic necrosis in spite of restoration of normal blood flow. On the other hand if the arterial occlusive process is gradual, as in aneurysm or arterioscrerotic occlusion, the peripheral muscles are able to maintain its viability, because there is enough period for the collateral circulation to develop.
A 20 year old R.O.K. marine was evacuated to Chinhea Naval Hospital with the diagnosis of multiple fragment wounds of face, extremities and abdomen (perforation of small intestine and rupture of left common iliac artery). In Vietnam the patient had exploratory laparotomy with the primary repair of left common iliac artery and intestinal resection. Five days after evacuation to Korea, he suddenly developed severe abdominal pain, dyspnea and abdominal distention, which are soon followed by shock.
Immediate laparotomy showed ruptured pseudoaneurysm of the left common iliac artery which had been repaired at the time of initial operation in Vietnam. Lagaiton of the left common iliac artery was inevitably done as a life saving procedure because of uncontrollable massive hemorrhage and marked adhesion which was resulted from the previous operation. Clinical course was uneventful without any significant ischemic symtoms and signs, and six weeks after surgery aortogram revealed that the diameter of the internal and external iliac arteries distal to the ligation were reduced to two thirds of the opposite side and that many collateral circulations were evident. The patient has remained well over six months since the surgery, free from any symptoms of the ischemic leg. This is report of rare case, who tolerated well the ligation of the common iliac artery which was done for the ruptured pseudoaneurysm.
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