Spontaneous Rupture of the Left Common Iliac Vein: Management with Surgical Repair and Endovascular Stent

Abstract

We report here on a case of spontaneous rupture of the left common iliac vein that was diagnosed preoperatively with computed tomography (CT), and the patient was successfully treated with surgery and stent placement. A 60-year-old woman was referred to our emergency room because of sudden left lower abdominal pain and swelling of the left lower extremity. CT revealed a huge retroperitoneal hematoma and extrinsic compression of the left common iliac vein with acute thrombosis of the deep veins of the left lower extremity. Venous patch angioplasty was performed at the site of spontaneous rupture. After performing thrombectomy with using a Forgaty catheter, a stent was placed at the occluded segment of the left common iliac vein under C-arm fluoroscopic guidance. The follow-up CT scans taken at 10 days and 8 months after the initial examination demonstrated a venous stent with preserved luminal patency and the striking resolution of the deep vein thrombosis of the left lower extremity.

저자들은 수술 전 컴퓨터단층촬영으로 진단되어 수술과 스텐트삽입술로 성공적으로 치료한 자발성 장골정맥 파열 1예를 보고하고자 한다. 60세 여자환자로 갑작스런 좌하복부 통증과 이후 좌측 하지의 종창이 발생하여 응급실로 내원하였다. 컴퓨터단층촬영에서 후복막강내에 혈종이 관찰되었으며 좌측 장골정맥이 외부압박을 받고 있었고 좌측 하지정맥에 급성 혈전이 보였다. 파열부위를 대복재정맥으로 패치 봉합하였으며 Forgarty 도관으로 혈전을 제거한 후 장골정맥의 폐색부위에는 투시하에 스텐트를 삽입하였다. 시술 10일과 8개월 후 시행한 추적 컴퓨터단층 촬영에서 스텐트의 개존성은 유지되었으며 좌측 하지정맥의 혈전은 관찰되지 않았다.