22/08/2024
Happy to share a complex rare case done with multidisciplinary team approach
A 42 yr male C/o pain abdomen since 3 years , mass abdomen , diagnosed as large pseudoaneurysm of Abdominal Aorta just below B/L Renal artery origin. Quite complex for Endovascular Repair as very near to Renal arteries. Medically stabilised in CCU by our Cardiology team. Pts left ureter was compressed by the mass and had gross Hydronephrosis. Was thoroughly planned and Pre -op Left DJ stent put by our Urologist to decompress the palvi-calyceal system. Then took in OT ,our Gastro Surgeon, did laparotomy and helped us reach retroperitoneum with his great expertise as the mass was densely adherent to peritoneum and intestine. The mass was large size 15*12Cm approx and dense adhesions to nearby structures. Did Aorto- Bi Illiac Bypass with Collagen coated Y graft and closed the pseudo aneurysm opening with Patch and proximal and distal ends lighted with silk , The cavity was obliterated in multiple layers. Post op pt behaved well , now discharged on POD 8 walking and good hemodynamics. In Pt’s words he was able to sleep well after 3 years without pain abdomen.
A multidisciplinary team approach is beneficial in such complex cases .
We are doing all types of Complex Cardiac, Thoracic and Vascular cases in our department, CABG, Valve replacement, cardiac tumour, Aortic Dissection, VATS , Peripheral Bypass, all vascular cases, ECMO etc
Regards
Dr Manpreet S Salooja
Deputy Director
Cardio- Thoracic and Vascular Surgery
S.P.S Hospitals
