Abstract
In recent years, endovascular aortic repair (EVAR) has been applied to cases of ruptured abdominal aortic aneurysm and has been reported to have mortality rates similar to open-abdominal synthetic graft replacement. Here, we report a case in which abdominal compartment syndrome (ACS) worsened after an emergency EVAR. A 62-year-old man had emergency EVAR performed on his abdominal aortic aneurysm, while an intra-aortic balloon occluder was placed in his descending aorta and the balloon was dilated. No endoleak was observed after the stent placement performed without the dilated balloon. However, his vital signs remained unstable, his abdominal bloating worsened, and his intra-abdominal pressure reached 50 mmHg, which led to ACS. We performed an emergency decompressive laparotomy, but the patient suffered cardiopulmonary arrest, and died during surgery. It may be important to perform early decompressive laparotomy if ACS is suspected, because, once ACS occurs, the probability of death increases even if the EVAR performed on ruptured aortic aneurysm is successful.
