A Case of Localized Abdominal Aortic Dissection Suspected to Have Simultaneously Occurred with an Idiopathic Esophageal Rupture

(Department of Thoracic and Cardiovascular Surgery, Nayoro City Hospital, Nayoro, Japan)

Keisuke Nakanishi Yuichi Izumi Katsuaki Magishi
Keijiro Mitsube Hiroshi Kubota
A 47-year-old man suffered an idiopathic esophageal rupture and an emergency operation was performed. Postoperative CT revealed an aortic dissection at the level of the infra-renal aorta and the right common iliac artery. The maximum diameter of the aorta was 3.0cm, and that of the right common iliac artery was 2.5cm with a patent false lumen. The operation was done using the right extra-peritoneal approach. When the infra-renal aorta was clamped and opened, the false lumen was located on the right anterior wall of the aorta. There were 3 communicating holes presumably being the points of entry or re-entry. A bifurcation Dacron graft was put into the aorta and the bilateral iliac artery. His postoperative course was good and he was discharged on the 15th day after surgery. In this case, since the patient had no history of severe pain except for the time of esophageal rupture, the localized abdominal aortic dissection was suspected to have simultaneously occurred with the idiopathic esophageal rupture.
@Jpn. J. Cardiovasc. Surg. 32F246 -249 (2003)