A CASE OF DUODENAL OBSTRUCTION DUE TO AN ABDOMINAL AORTIC ANEURYSM AFTER TRANSVERSE COLECTOMY

Abstract

Duodenal obstruction due to an abdominal aortic aneurysm is rare. We experienced a case of duodenal obstruction due to an abdominal aortic aneurysm after transverse colectomy.
An 86-year-old woman was admitted to the hospital because of anorexia and an abdominal mass. Preoperative abdominal CT scan demonstrated an abdominal mass originated from the transverse colon, an abdominal aortic aneurysm and a right common iliac artery aneurysm. Horizontal portion of duodenum ran in front of the infra-renal aortic aneurysm on contrast enhanced CT scan. Because of high probability of malignancy, transverse colectomy was performed as the first stage operation. On the 6th postoperative day obstruction of the duodenum occurred. Abdominal CT scan with contrast demonst-rated a narrowing horizontal potion of duodenum which was compressed by the aortic aneurysm and abdominal wall. Open repair for the abdominal aortic aneurysm and iliac artery aneurysm was performed by using Y graft, resulting in an immediate relief of duodenal obstruction.