Aneurisma de art谷ria il赤aca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

作者：Cristina Toledo Afonso; Ricardo Jayme Procopio; Tulio Pinho Navarro; Gustavo Henrique Dumont Kleinsorge

来源：Jornal Vascular Brasileiro, 2009.

• Aneurisma roto
• arteria iliaca
• abdome agudo
• Ruptured aneurysm
• iliac artery
• acute abdomen

Aneurismas isolados da art谷ria il赤aca interna s o raros, acometem 0,1% da popula o e correspondem a 1% dos aneurismas aorto-il赤acos. Na maioria das vezes, os pacientes s o assintom芍ticos, mas podem apresentar dor abdominal, massa puls芍til no hipog芍strio ou na fossa il赤aca, sintomas compressivos urin芍rios, gastrointestinais ou neurol車gicos. Podem ocasionar quadro de abdome agudo, principalmente quando h芍 ruptura. O diagn車stico precoce dos aneurismas isolados de art谷ria il赤aca interna 谷 incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu progn車stico mais reservado. Dessa forma, representam um desafio terap那utico. A ligadura cir迆rgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. 谷 relatado caso de aneurisma de art谷ria il赤aca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo. Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach) is reported.