Abstract
BackgroundPseudoaneurysms 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 presentationThe 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.ConclusionThese complications occur extremely rarely after cystectomy with pelvic lymphadenectomy. There are no reports to date on these complications following laparoscopic cystectomy with pelvic lymphadenectomy.
Highlights
Pseudoaneurysms are caused by trauma, tumors, infections, vasculitis, atherosclerosis and iatrogenic complications [1]
We report about a patient with rupture of an external iliac artery pseudoaneurysm, which lead to hemorrhagic shock, after undergoing laparoscopic radical cystectomy, extended pelvic lymphadenectomy and ileal conduit diversion
Ricciardi et al reported a case of external iliac artery pseudoaneurysm rupture following pelvic lymphadenectomy for cervical cancer [2]
Summary
It is extremely rare for formation and rupture of an iliac artery pseudoaneurysm after pelvic surgery. We report about a patient with rupture of an external iliac artery pseudoaneurysm, which lead to hemorrhagic shock, after undergoing laparoscopic radical cystectomy, extended pelvic lymphadenectomy and ileal conduit diversion. Case presentation The patient was a 68-year-old Japanese male diagnosed with invasive bladder cancer with clinical stage T3a N0 M0 (Figure 1). His body mass index (BMI) was 17.4 kg/m2. A pedunculated femoral flap and split-thickness skin graft were performed to cover the inguinal wound, and the patient was discharged home 12weeks after initial surgery. At twelve months follow up, there was no evidence of aneurysm recurrence and no prolonged limb deficit
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