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• W2068301512 abstract "The spontaneous rupture of the abdominal aorta and specially that of the iliac arteries is seldom published in the literature, since the thoracic aorta is more frequently involved. We present our experience with two cases: a 78 year-old woman with important associated pathology and spontaneous rupture of the infrarenal abdominal aorta and a 65 year-old man with rupture of the left common iliac artery; both patients were admitted and treated urgently in our department; in the case of the rupture of the aorta a left aortoiliac endoprosthesis was deployed, the right common iliac artery occluded and a femorofemoral bypass was performed whereas in the case of the rupture of the iliac artery an iliofemoral by-pass was performed. Owing to a multiorgan failure the woman died within the first postoperative days, whereas the man had no complications. With regard to the penetrating atherosclerotic ulcers that cause these ruptures and the best diagnostic methods, specially CT scan and nuclear magnetic resonance we review the literature. An early diagnostic of these penetrating ulcers is important in order to prevent the perforation of the arterial wall, which may provoke a high mortality rate, specially among those patients with severe associated pathology even similar to that of the ruptured aneurysms. La rotura espontánea de la aorta abdominal y, sobre todo, de las arterias ilíacas, es un hecho que raramente se publica en la bibliografía, ya que es la aorta torácica la queda afectada con mayor frecuencia. Presentamos nuestra experiencia con dos casos: una paciente de 78 años con una importante patología asociada y con rotura espontánea de la aorta abdominal infrarrenal, y un paciente de 65 años con rotura de la arteria ilíaca común izquierda. Ambos ingresaron y se trataron de urgencia en nuestro servicio; se les practicó la implantación de una endoprótesis aortoilíaca izquierda, una oclusión de la ilíaca primitiva derecha y una derivación femorofemoral en el caso de la rotura aórtica e iliofemoral izquierda en el caso de la rotura ilíaca. La paciente falleció en el posoperatorio inmediato debido a un fracaso multiorgánico, mientras que el paciente evolucionó favorablemente. Se realiza una revisión de la bibliografía en relación con las úlceras arterioscleróticas penetrantes de aorta, causantes en su evolución de estas roturas, y sobre los actuales métodos diagnósticos, especialmente la tomografía computarizada y la resonancia magnética. Es importante pensar en la existencia de estas úlceras arterioscleróticas penetrantes, que en su evolución pueden ocasionar la perforación de la pared arterial y provocar, sobre todo en los pacientes con una patología asociada importante, una elevada mortalidad que puede incluso ser similar a la de la rotura de los aneurismas de aorta. A rotura espontânea da aorta abdominal e, sobre tudo, das artérias ilíacas, é um facto que raramente se publica na bibliografia, uma vez que é a aorta torácica a ser afectada com maior frequência. Apresentamos a nossa experiência com dois casos: uma doente com 78 anos de idade com uma importante patologia associada e com rotura espontânea da aorta abdominal infra-renal, e um doente de 65 anos de idade com rotura da aorta ilíaca comum esquerda. Ambos foram internados e tratados com urgência no nosso serviço; realizou-se uma implantação de endoprótese aorto-ilíaca esquerda, oclusão da ilíaca primitiva direita e um by-pass fémoro-femoral no caso da rotura aórtica e by-pass íleo-femoral esquerdo no caso da rotura ilíaca. A doente faleceu no pósoperatório imediato devido a falência multiorgânica, enquanto que o doente evoluiu favoravelmente. Realiza-se uma revisão da bibliografia em relação às úlceras arterioscleróticas penetrantes da aorta, causadoras, na sua evolução, destas roturas, e dos actuais métodos de diagnóstico, especialmente a tomografia computorizada e a ressonância magnética. É importante pensar na existência destas úlceras arterioscleróticas penetrantes, que na sua evolução podem ocasionar a perfuração da parede arterial e provocar, especialmente em doente com patologia associada importante, uma elevada mortalidade que inclusive pode ser similar à da rotura dos aneurismas da aorta." @default.
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• W2068301512 date "2003-01-01" @default.
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• W2068301512 title "Rotura espontánea aortoilíaca: presentación de dos casos" @default.
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• W2068301512 doi "https://doi.org/10.1016/s0003-3170(03)74835-4" @default.
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