• Title/Summary/Keyword: Abdominal aorta

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Factors Affecting the Postoperative Mortality in the Ruptured Abdominal Aortic Aneurysm

  • Ahn, Hyo-Yeong;Chung, Sung-Woon;Lee, Chung-Won;Kim, Min-Su;Kim, Sang-Pil;Kim, Chang-Won
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.230-235
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    • 2012
  • Background: Although patients with a ruptured abdominal aortic aneurysm (RAAA) often reach the hospital alive, the perioperative mortality is still very high. We retrospectively reviewed thirty patients who underwent repair of RAAA to identify the factors affecting postoperative mortality in a single hospital. Materials and Methods: Between September 2007 and May 2011, thirty patients with RAAA underwent emergent surgery (n=27) or endovascular aneurysm repair (n=3). Their medical records were retrospectively reviewed regarding three categories: 1) preoperative patient status: age, gender, vital signs, serum creatinine, blood urea nitrogen, hematocrit, and hemoglobin level: 2) aneurysmal status: size, type, and rupture status; and 3) operative factors: interval time to operating room, operative duration, and amount of perioperative transfusion. Results: The 30-day postoperative mortality rate was 13.3% (4/30); later mortality was 3.3% (1/30). On multivariate analysis, the initial diastolic blood pressure (BP), interval time to operating room and amount of preoperative packed cell transfusion were statistically significantly linked with postoperative mortality (p<0.05). Conclusion: In this study, preoperative diastolic BP, preoperative packed cell transfusion amount and interval time between arrival and entry to operating room were significantly associated with postoperative mortality. It is important to prevent hemorrhage as quickly as possible.

Idiopathic Arterial Thromboembolism(ATE) in a Turkish Angora Cat (터키산 앙고라(Turkish Angora) 고양이에서 발생한 특발성 동맥 색전혈전증(arterial thromboembolism: ATE) 1례)

  • Han, Sung-Kuk;Kim, Jung-Hyun;Jeong, Soon-Wuk;Park, Hee-Myung;Park, Chul;Yoo, Jong-Hyun
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.23-26
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    • 2008
  • A 2-year-old, female, Turkish Angora cat was presented due to hindlimb paralysis with 2-day history of vomiting and depression. Physical examination revealed weak femoral pulse and cyanotic footpads of hind limbs. Chest auscultation, thoracic radiography, and electrocardiogram were no remarkable. Abdominal ultrasonography showed suspected hyperechoic thrombus in abdominal aorta. Underlying causes of the arterial thromboembolism were not found on multiple diagnostic examinations and the cat was diagnosed as idiopathic saddle thromboembolism. Despite 4-week regimen with heparin sodium, aspirin, and diltiazem, the hind limbs were progressively and irreversibly necrotized. Therefore, coxofemoral amputation was performed. After surgery, the clinical condition of this cat returned to normal without further complications.

Both Carotid Endarterectomy in Obstrution of Carotid Arteries and Bypass Graft with Kidney Preservation in Obstrution of Abdominal AoRta -A Report of Case (양측 경동맥협착의 혈관내막절제수술 및 신장보호액 주입을 이용한 복부대동백 폐색 수술 치험 -1례 보고-)

  • 김병철;편승환
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.625-630
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    • 1997
  • A 56 years old male patient adklitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. (infers and weakness on grasping, which were progressively developed re ently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We plamled staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later We obligately clamped aorta just below the celiac artery and infuse4 kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative courts was uneventful and patient was discharged without any specific problem.

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A Case Report on Acupuncture and Moxibustion Treatment of a Patient with Immunoglobulin A Nephropathy (IgA 신병증 환자의 침구 치료 치험 1례)

  • Lee, Min-seong;Oh, Seung-hyun;Jung, Woo-nyoung;Noh, Ji-won;Ahn, Young-min;Ahn, Se-young;Lee, Byung-cheol
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.1037-1044
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    • 2022
  • Objective: This study was conducted to investigate whether acupuncture and moxibustion treatment could improve proteinuria in immunoglobulin A nephropathy. Methods: A 25-year-old man diagnosed with immunoglobulin A nephropathy had severely increased proteinuria. We conducted acupuncture treatment and moxibustion treatment on the abdominal area between the abdominal aorta and kidney at level L2. Results: After five months of acupuncture and moxibustion treatment, the patient's urine albumin/creatinine ratio and urine protein/creatinine ratio had improved from 0.571 to 0.28 and 0.79 to 0.47, respectively. Conclusions: This case report suggests that acupuncture and moxibustion treatment may ameliorate proteinuria in immunoglobulin A nephropathy.

A Rare Case of Canine Huge Renal Cell Carcinoma with Ovarian Metastasis

  • Koo, Jiyoung;Song, Woo-Jin;Jo, Heesoo;Ahn, Hyerin;Choi, Solji;Jeong, Hyohoon;Cheong, Jongtae;Park, Hyun-Jung;Yun, Youngmin
    • Journal of Veterinary Clinics
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    • v.39 no.4
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    • pp.168-172
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    • 2022
  • A 10-year-old female Pomeranian weighing 2.25 kg with a history of gradual weight loss and an intraabdominal mass confirmed with ultrasonography at a local hospital was referred to the Veterinary Medical Teaching Hospital, Jeju National University. Physical examination revealed abdominal distention. Blood analysis revealed hypoglycemia (57 mg/dL; reference range, 60-110 mg/dL). On abdominal ultrasonography, a heterogeneously hyperechoic mass measuring 7.51 × 10.6 cm was found at the level of the left kidney. Computed tomographic findings showed a unilateral left kidney mass with a 10-cm diameter and vessel contrast enhancement in the corticomedullary phase. Unilateral nephrectomy and ovariohysterectomy were performed because left ovary enlargement was observed during surgery. The renal mass was adjacent to the aorta and vena cava and attached to a portion of the small intestine, greater omentum, and left ovary. The mass was huge (12.5 × 10 × 7 cm) and was 16.5% of the body weight. Histopathological examination revealed renal cell carcinoma (RCC) and ovarian metastasis. After surgery, clinical signs improved remarkably, and serum glucose level returned to normal. As RCC is resistant to radiation and chemotherapy, the owner decided not to proceed with postoperative adjunctive therapies. To the best of our knowledge, this is the first case report of ovarian metastasis with huge RCC in a dog.

A Case of Tuberculosis Presented with Pseudoaneurysm of the Aorta and Acute Respiratory Distress Syndrome (복부 대동맥 가성동맥류와 급성호흡곤란증후군으로 동시에 발현한 결핵)

  • Lee, Eung-Jun;Cho, Han-Su;Yoon, Hyun-Sung;Lee, Jung-Hyun;Lee, Tae Hoon;Yoo, Kwang Ha;Lee, Kye Young;Kim, Sun Jong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.298-302
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    • 2008
  • We experienced a case of tuberculosis presented simultaneously with pseudoaneurysm of the aorta and ARDS. A 63-year-old man was admitted with complaints of fever and right upper quadrant abdominal pain for a week. Chest X-ray on admission showed a normal finding. Sub-diaphragmatic abscess on abdomen CT scan was suspected and serosanguinous fluid was aspirated from the abscess pocket. On day 2, he was getting more dyspneic and chest X-ray revealed extensive bilateral infiltration. Aspirated fluid revealed AFB. Later, follow-up abdomen CT scan revealed a leakage of dye from the aneurysmal sac of the descending aorta which was previously diagnosed as sub-diaphragmatic abscess. An aortic stent was placed, covering the opening into the aneurysm. The sputum also showed positive AFB. The patient was successfully weaned from the ventilator, and discharged with anti-tuberculous medication on day 42. Follow-up abdomen CT scan 6 months later showed that the aneurymal sac was completely disappeared.

Clinical Study of the Treatments for Abdominal Aortic Aneurysm; Comparison between the Retroperitoneal and Transperitoneal Approaches (복부대동맥류 치료의 임상적 고찰; 후복막 접근법과 경복막 접근법의 비교)

  • Son, Bong Soo;Chung, Sung Woon;Lee, Sang Kwon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.34-40
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    • 2009
  • Background: The principal surgical technique for treating an abdominal aortic aneurysm since the 1960s has been the transperitoneal approach, yet there have been some recent studies that have reported improved surgical results with using the retroperitoneal approach. However, there are only limited clinical Korean studies that have, compared between the transperitoneal and retroperitoneal approaches. Material and Method: This study included 36 patients who had been diagnosed as having an aneurysm of the abdominal aorta and they were surgically treated between January 2001 and July 2007. The patients were subdivided into the retroperitoneal approach group (n=17) and the transperitoneal approach group (n=19), and they were compared in terms of the preoperative risk factors, the postoperative complications and the operative mortality. The risk factors of operative mortality risk and long-term survival for the 36 patients were assessed by the Kaplan-Meier method. Result: There were no significant differences between the groups in terms of gender, age, the underlying disease, a history of smoking, rupture of aneurysm, the preoperative symptoms, the operation time and the incidence of postoperative complications. However, the duration of postoperative fasting, the number of days of having an indwelling nasogastric tube and the length of the stay in the intensive care unit were significantly short for the retroperitoneal approach group (p<0.05). There was a 16.7% rate of operative mortality (6/36) and five of the deaths were attributed to preoperative ruptured aneurysm. On univariate analysis, a higher preoperative serum creatinine level (SCr ${\geq}$1.8 mg/dL, p=0.016) and ruptured aneurysm (p<0.001) were the significant risk factors of operative mortality. As assessed by the Kaplan-Meier method, the long-term survival was comparable between the groups and the five-year survival rate of all the patients was 57.5%. Conclusion: In the present study, a retroperitoneal approach has several advantages such as a shorter intensive care unit stay, a shorter duration of postoperative fasting and a shorter duration of an indwelling nasogastric tube. Therefore, unless there is any contraindication for a retroperitoneal approach, it could be considered as a primary surgical access for repairing an abdominal aortic aneurysm.

The Distribution of the Renal Artery in the Canine Kidney (견신동맥(犬腎動脈)의 분포상태(分布狀態))

  • Kim, Yong Keun;Kim, Chong Sup;Kim, Moo Kwang
    • Korean Journal of Veterinary Research
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    • v.13 no.2
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    • pp.103-109
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    • 1973
  • By employing the vinylite and neoprene latex corrosion technique, the ramification and arrangement of A. renalis were observed in fifty adult dogs (100 kidneys). Obtained results were as follows: 1. In the dog a single renal artery arosed on each side from abdominal aorta in 99% and double renal arteries in 1%, a single bifurcated into the ramus dorsalis and ramps ventralis from which 2-6 segmental arteries originated. 2. The dorsal ventral planes of the kidney were divided separately into 3-6 vascular segments by the segmental artery into the parenchyma. Of them four segments were mostly frequent (in 73% of right kidney and 72% of left). 3. The ramifying method of the segmental artery from the ramus dorsalis et ventralis was divided 3 types and 12 kinds. 4. In 30 of 100 kidneys, either dorsal or ventral plane of a kidney was supplied from interlobar or segmental arteries belonging to the opposite ramps. In 29 of them, the dorsal plane was supplied from the ventral ramus. 5. Six right and 11 left kidneys had a common segment in the Extremitas cranialis of the kidney.

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Type A Aortic Dissection with Aortocaval Fistula -Report of 1 case- (대동맥-상대정맥루를 동반한 A형 대동맥 해리증 수술 치험 -1례보고-)

  • 김흥수;양승인;정성운;김종원;이형렬
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.599-604
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    • 2002
  • Acute or chronic aortic dissection may lead to the rupture, which is the major cause of death. A dissecting aneurysm of ascending aorta(Stanford type A dissection) can rupture into the superior vena cava producing a aortocaval fistula, which is rare, but has been reported mostly in the cases of abdominal aortic aneurysm. We report a case of 67-year-old man with type A chronic dissection and aortocaval fistula, presenting symptoms of superior vena syndrome. The preoperative diagnosis was composed of radiologic examinations, including computed tomography, magnetic resonance imaging angiography and aortography. The dissecting aneurysm was resected and replaced, and the aortocaval fistula was repaired under deep hypothermic circulatory arrest. The details are described here.

Aortoenteric Fistula -one case report- (대동맥장루 -1예 보고-)

  • Kim, Hyuck;Jung, Tae-Yol;Ban, Dong-Gyu;Chung, Won-Sang;Kim, Young-Hak;Kang, Jung-HO;Jee, Heng-Ok;Lee, Chul-Bum;Kwon, Oh-Jung;Kim, Kyung-Soo
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.176-179
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    • 2001
  • 이차성 대동맥장루는 아주 드물며 대동맥-장골동맥의 재건수술의 중대한 합병증으로 발생할 수 있다. 이 질환은 진성 대동맥장루와 paraprosthetic enteric fistula 로 분류할 수 있다. 이러한 합병증의 예방, 진단 및 치료는 추구해야할 문제로 되어 있다. 염증성 가성동맥류로 복부대동맥 및 장골동맥을 인조혈관으로 치환한 후 41개월에 내시경으로 Paraprosthetic enteric Fistula로 진단되어 수술을 시행한 39세 남자환자를 치험하였기에 보고한다.

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