2020 Volume 29 Issue 2 Pages 125-129
The spontaneous rupture of an ovarian artery aneurysm is extremely rare and can be fatal. A 72-year-old woman, gravida 2 para 2, who had not undergone cesarean section, presented with disturbance of consciousness and shock. Contrast-enhanced computed tomography (CT) revealed rupture of a giant right ovarian artery aneurysm with a maximum minor axis diameter of 71 mm. It originated from the right accessory renal artery and the pelvic arteriovenous fistula with feeding arteries including the right ovarian artery. She was transferred to our institution, and we considered that it would be difficult to perform coil embolization because both the proximal and distal blood vessels of the aneurysm were not suitable due to their large diameter. Therefore, she underwent ligation of the proximal and distal blood vessels through a median laparotomy on an emergent basis. Her postoperative course was uneventful and contrast-enhanced CT did not show inflow of contrast medium into the aneurysm. However, the pelvic arteriovenous fistula was reduced but still remained; therefore, coil embolization was performed. This is a very rare case of a patient who had a ruptured ovarian artery aneurysm with a pelvic arteriovenous fistula.
