Abstract
We report possibly the oldest patient in the world with both a ruptured abdominal aortic aneurysm and shock who was saved by accurate diagnosis and immediate treatment by trained medical teams specializing in emergency medicine, radiology, vascular surgery, anesthesiology, and internal medicine. The 96-year-old patient was transferred to our hospital because of sudden left lateral abdominal pain and hypotension that resulted in periods of unconsciousness and shock. An enhanced CT scan showed that the ruptured infrarenal abdominal aortic aneurysm was surrounded by hematoma that was located mainly in the left lateral abdomen, extended above the renal arteries (Fitzgerald type III), and was 7cm at its maximum diameter. Y-graft replacement was successfully performed after a rapid decrease in the patient's blood pressure was quickly restored by clamping the aortic neck by hand. Following the operation the patient developed ischemic colitis and cholecystitis, which were cured by conservative treatment. The patient was discharged 20 days after the operation. We were able to save this nonagenarian patient with both a ruptured abdominal aortic aneurysm and shock by immediate treatment provided by medical teams that are trained and coordinated.
