A Case of Abdominal Aortic Rupture Treated by Chimney EVAR

Abstract

A 62-year-old woman with a history of 4 laparotomy procedures for lymph node metastasis after left hemicolectomy underwent left-sided nephrectomy and abdominal aortic repair. After discharge, as a sudden onset of intraperitoneal bleeding via the drain developed, the patient was transferred to our institution and diagnosed with abdominal aortic rupture (AAR) due to postoperative peritonitis induced by anastomotic leakage in rectal surgery. On admission, computed tomography revealed extravasation of contrast medium around the abdominal aorta. Judging from a case of aortic rupture with severe adhesions in the abdominal cavity, we adopted a policy that surgical management by endovascular aortic repair with the Chimney technique (Ch-EVAR) should be performed. The patient had an uneventful postoperative recovery without endoleaks or renal dysfunction. This case highlights the difficulty of managing AAR and provides insight into a successful Ch-EVAR for AAR without endoleaks or renal dysfunction.