A Successful Case of Retroperitoneal Hematoma Evacuation and Aneurysmorrhaphy for Difficulty of Abdominal Closure Due to Abdominal Compartment Syndrome after Endovascular Aortic Repair of Ruptured Abdominal Aortic Aneurysm

Abstract

Hereon, we report the performance of emergent endovascular aortic repair in an 85-year-old female for a ruptured abdominal aortic aneurysm of 10 cm. An intra-aortic occlusion balloon was inserted preoperatively from the left brachial artery for hemodynamic stability. After endovascular aortic repair, open abdominal management was required to treat the onset of abdominal compartment syndrome. We could not close the abdomen owing to retroperitoneal swelling, therefore, we used computed tomography to ensure there was no major leak, before removing retroperitoneal hematoma. We opened the residual abdominal aneurysm, removed the hematoma around the stent-graft in the aneurysm, and performed aneurysmorrhaphy. The retroperitoneal swelling was improved, and we could close the abdomen easily.