Abstract
Abdominal aortic aneurysm (AAA) surgery is frequently complicated by gastro-intestinal events, but ileus caused by small intestinal, especially duodenal, obstruction is far more uncommon. We reported a case of the duodenal obstruction following ruptured aortic aneurysm resection which was caused by a perigraft seroma. A 77-year-old man with a ruptured AAA underwent aortic repair using an aorta-biiliac graft. The operation was uneventful, but the patient vomited frequently just after he commenced on oral intake. Computed tomography showed compression of the duodenal third portion by an aneurysm sac filled with low density fluid and remarkable dilatation of the proximal duodenal lumen. He was treated conservatively with total parenteral nutrition (TPN) and naso-gastric tube aspiration. Dietary intake was restarted on the 33rd postoperative day and he was weaned from TPN without any trouble. The patient was discharged 45 days after operation. We consider that duodenal obstruction caused by a perigraft seroma would resolve spontaneously, and thus should be treated conservatively.
