Abdominal Compartment Syndrome Complicating Emergency Endovascular Aneurysm Repair for Ruptured Common Iliac Artery Aneurysm

Youichi Yanagawa^1, , Hiroki Nagasawa¹, Hiroaki Taniguchi¹, Atsumi Oishi² and Munehiro Sugiyama³

¹Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University

²Department of Cardiovascular Surgery, Shizuoka Hospital, Juntendo University

³Department of Radiology, Shizuoka Hospital, Juntendo University

Cite this paper:
Youichi Yanagawa, Hiroki Nagasawa, Hiroaki Taniguchi, Atsumi Oishi and Munehiro Sugiyama. Abdominal Compartment Syndrome Complicating Emergency Endovascular Aneurysm Repair for Ruptured Common Iliac Artery Aneurysm. American Journal of Medical Case Reports. 2024; 12(8):114-116. doi: 10.12691/ajmcr-12-8-2

Abstract

This case report describes a 62-year-old male who presented with left-sided abdominal and lower back pain following a fall, which was followed by a vehicular accident resulting in a helicopter evacuation. Upon arrival, he exhibited signs of shock, including bradycardia and hypotension, with imaging revealing a ruptured left common iliac artery aneurysm (CIAA) and retroperitoneal hematoma. Emergency stent graft placement and embolization were performed, but intraoperative complications led to significant bleeding and the development of abdominal compartment syndrome (ACS). Despite surgical intervention, the patient succumbed to pulseless electrical activity. This case highlights the challenges in managing ruptured isolated CIAAs and the potential for complications such as ACS. Early recognition and prompt intervention are crucial, and consideration of radical or decompressive surgery may be warranted to prevent ACS in similar cases.

Keywords:
left common iliac artery aneurysm shock abdominal compartment syndrome

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Charisis N, Bouris V, Rakic A, et al. A systematic review on endovascular repair of isolated common iliac artery aneurysms and suggestions regarding diameter thresholds for intervention. J Vasc Surg. 2021; 74(5): 1752-1762.
[2]	Moldovan H, Tiganasu R, Câlmâc L, et al. Same Clinical Reality of Spontaneous Rupture of the Common Iliac Artery with Pseudoaneurysm Formation-Comparison of Two Therapeutical Solutions, Endovascular Stent-Graft and Open Surgical Correction, for Two Cases and Review of the Literature.J Clin Med. 2023; 12(2): 713.
[3]	Sandhu RS, Pipinos II. Isolated iliac artery aneurysms. Semin Vasc Surg. 2005; 18: 209-215.
[4]	Hechelhammer L, Rancic Z, Pfiffner R, et al. Midterm outcome of endovascular repair of ruptured isolated iliac artery aneurysms. J Vasc Surg. 2010; 52(5): 1159-63.
[5]	Gardiner MD, Mangwani J, Williams WW. Aneurysm of the common iliac artery presenting as a lumbosacral plexopathy. J Bone Joint Surg Br. 2006; 88(11): 1524-6.
[6]	Shimabukuro K, Miyauchi T, Takemura H. Rupture of left common iliac artery aneurysm. J Vasc Surg. 2007; 45(5): 1083.
[7]	Aizawa K, Ohki S, Misawa Y.Open Surgical Decompression Is Useful for the Prevention and Treatment of Abdominal Compartment Syndrome after the Repair of Ruptured Abdominal Aortic and Iliac Artery Aneurysm.Ann Vasc Dis. 2018; 11(2): 196-201.
[8]	Ferreira J, Canedo A, Barreto P, et al.Abdominal compartment syndrome after endovascular repair of ruptured iliac artery aneurysm. Interact Cardiovasc Thorac Surg. 2012; 14(6): 897-9.
[9]	Krupski WC, Selzman CH, Floridia R, et al. Contemporary management of isolated iliac aneurysms. J Vasc Surg. 1998; 28(1): 1-11.