Life-threatening rupture of an external iliac artery pseudoaneurysm caused by necrotizing fasciitis following laparoscopic radical cystectomy: a case report

BMC Research Notes

Hiromitsu Mimata¹  Fuminori Satoh¹  Yasuhiro Sumino¹  Kenichi Mori¹  Toshitaka Shin¹  Ryuta Satoh¹  Shinro Hata¹ 

[1] Department of Urology, Faculty of medicine, Oita University, Idaigaoka 1-1, Hasama-cho, Yufu, Oita Prefecture 879-5593, Japan

关键词: Pelvic lymphadenectomy;    Laparoscopic;    Pseudoaneurysm;    Bladder cancer;   

Others  :  1132805
DOI  :  10.1186/1756-0500-7-290

 received in 2013-12-18, accepted in 2014-05-07,  发布年份 2014

【 摘 要 】

Background

Pseudoaneurysms are caused by trauma, tumors, infections, vasculitis, atherosclerosis and iatrogenic complications. In this paper, we report about a patient with rupture of an external iliac artery pseudoaneurysm, which lead to hemorrhagic shock, after undergoing laparoscopic radical cystectomy and extended pelvic lymphadenectomy.

Case presentation

The patient was a 68-year-old Japanese male diagnosed with invasive bladder cancer. Laparoscopic radical cystectomy and extended pelvic lymphadenectomy were performed. On postoperative day 12, he developed a high fever and an acute inflammatory response with redness and swelling in the right inguinal region. He was diagnosed with necrotizing fasciitis and underwent debridement. On postoperative day 42, a sudden hemorrhage developed from the open wound in the right inguinal region. He was diagnosed with external iliac artery pseudoaneurysm rupture by computed tomography.

Conclusion

These complications occur extremely rarely after cystectomy with pelvic lymphadenectomy. There are no reports to date on these complications following laparoscopic cystectomy with pelvic lymphadenectomy.

【 授权许可】

   
2014 Hata et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Sueyoshi E, Sakamoto I, Nakashima K, Minami K, Hayashi K: Visceral and peripheral arterial pseudoaneurysms. AJR Am J Roentgenol 2005, 185(3):741-749.
• [2]Enzo R, Giampaolo Di M, Paolo M, Mauro S, Antonio F, Marina J, Borut K, Massimo M: Life-threatening bleeding after pelvic lymphadenectomy for cervical cancer: endovascular management of ruptured false aneurysm of the external iliac artery. World J Surg Oncol 2012, 10:149. BioMed Central Full Text
• [3]Huang W-Y, Huang C-Y, Chen C-A, Hsieh C-Y, Cheng W-F: Ruptured pseudoaneurysm of the external iliac artery in an advanced cervical cancer patient treated by endovascular covered stent placement. J Formos Med Assoc 2008, 107(4):348-351.
• [4]Hampson SJ, Buckenham T, Patel A, Woodhouse CR: False aneurysm of the common iliac artery after pelvic lymphadenectomy: management of an unusual complication. J Urol 1996, 154:201-202.
• [5]Huang J, Lin T, Liu H, Kewei X, Zhang C, Jiang C, Huang H, Yao Y, Guo Z, Xie W: Laparoscopic radical cystectomy with orthotopic ileal neobladder for bladder cancer: oncologic results of 171 cases with a median 3-year follow-up. Eur Urol 2010, 58:442-449.
• [6]Desai MM, Berger AK, Brandina RR, Zehnder P, Simmons M, Aron M, Skinner EC, Gill IS: Robotic and laparoscopic high extended pelvic lymph node dissection during radical cystectomy: technique and outcomes. Eur Urol 2012, 61:350-355.
• [7]Christopher S, Nasreldin M, Stefano A, Gerit T, Vincenzo Maria A, Paolo F, Francesco G: Laparoscopic radical cystectomy with extracorporeal ileal neobladder for muscle-invasive urothelial carcinoma of the bladder: technique and short-term outcomes. World J Urol 2014, 32(2):407-412.