Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1
Abstract Background Neurofibromatosis type 1 (NF1) is an autosomal dominant disease of the skin and soft tissue. Aneurysms associated with NF1 can occur, but a secondary aneurysm rupture is very rare, with very few cases reported in literature. Case presentation We describe the case of a 67-year-old...
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doaj-8db5e2909f3b4c8cbd133a1d0f9481d32020-11-25T02:22:49ZengSpringerOpenSurgical Case Reports2198-77932019-01-01511710.1186/s40792-019-0570-4Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1Kazuki Moro0Hitoshi Kameyama1Kaoru Abe2Junko Tsuchida3Yosuke Tajima4Hiroshi Ichikawa5Masato Nakano6Mayuko Ikarashi7Masayuki Nagahashi8Yoshifumi Shimada9Kaori Kato10Takeshi Okamoto11Hajime Umezu12Emmanuel Gabriel13Masanori Tsuchida14Toshifumi Wakai15Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental SciencesDepartment of Surgery, Mayo ClinicDivision of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesAbstract Background Neurofibromatosis type 1 (NF1) is an autosomal dominant disease of the skin and soft tissue. Aneurysms associated with NF1 can occur, but a secondary aneurysm rupture is very rare, with very few cases reported in literature. Case presentation We describe the case of a 67-year-old female with NF1 who underwent endovascular aneurysm repair (EVAR) for an abdominal aortic aneurysm (AAA) rupture. She developed a type Ib endoleak requiring a redo-EVAR. Eighteen days after her primary operation, she was found to have two new left colic artery aneurysms. She required emergency surgery consisting of a left hemicolectomy and transverse colon colostomy. Pathology showed neurofibromatous changes to the peri-vasculature tissue, consistent with her underlying disease. Conclusions Although rare, secondary aneurysms can occur following AAA repair. Patients with soft tissue connective tissue disorders, like NF1, may be at an increased risk for development of these secondary aneurysms. Endovascular repair appears to be a safe approach for NF1 patients with AAA, but endovascular management can be challenging in the setting of NF1. Surgeons should be ready to convert to open surgery if the patient displays persistent signs of bleeding or structural changes related to connective tissue disorders like NF1.http://link.springer.com/article/10.1186/s40792-019-0570-4AneurysmLeft colic arteryLeft hemicolectomyNeurofibromatosis type 1von Recklinghausen disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kazuki Moro Hitoshi Kameyama Kaoru Abe Junko Tsuchida Yosuke Tajima Hiroshi Ichikawa Masato Nakano Mayuko Ikarashi Masayuki Nagahashi Yoshifumi Shimada Kaori Kato Takeshi Okamoto Hajime Umezu Emmanuel Gabriel Masanori Tsuchida Toshifumi Wakai |
spellingShingle |
Kazuki Moro Hitoshi Kameyama Kaoru Abe Junko Tsuchida Yosuke Tajima Hiroshi Ichikawa Masato Nakano Mayuko Ikarashi Masayuki Nagahashi Yoshifumi Shimada Kaori Kato Takeshi Okamoto Hajime Umezu Emmanuel Gabriel Masanori Tsuchida Toshifumi Wakai Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1 Surgical Case Reports Aneurysm Left colic artery Left hemicolectomy Neurofibromatosis type 1 von Recklinghausen disease |
author_facet |
Kazuki Moro Hitoshi Kameyama Kaoru Abe Junko Tsuchida Yosuke Tajima Hiroshi Ichikawa Masato Nakano Mayuko Ikarashi Masayuki Nagahashi Yoshifumi Shimada Kaori Kato Takeshi Okamoto Hajime Umezu Emmanuel Gabriel Masanori Tsuchida Toshifumi Wakai |
author_sort |
Kazuki Moro |
title |
Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1 |
title_short |
Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1 |
title_full |
Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1 |
title_fullStr |
Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1 |
title_full_unstemmed |
Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1 |
title_sort |
left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1 |
publisher |
SpringerOpen |
series |
Surgical Case Reports |
issn |
2198-7793 |
publishDate |
2019-01-01 |
description |
Abstract Background Neurofibromatosis type 1 (NF1) is an autosomal dominant disease of the skin and soft tissue. Aneurysms associated with NF1 can occur, but a secondary aneurysm rupture is very rare, with very few cases reported in literature. Case presentation We describe the case of a 67-year-old female with NF1 who underwent endovascular aneurysm repair (EVAR) for an abdominal aortic aneurysm (AAA) rupture. She developed a type Ib endoleak requiring a redo-EVAR. Eighteen days after her primary operation, she was found to have two new left colic artery aneurysms. She required emergency surgery consisting of a left hemicolectomy and transverse colon colostomy. Pathology showed neurofibromatous changes to the peri-vasculature tissue, consistent with her underlying disease. Conclusions Although rare, secondary aneurysms can occur following AAA repair. Patients with soft tissue connective tissue disorders, like NF1, may be at an increased risk for development of these secondary aneurysms. Endovascular repair appears to be a safe approach for NF1 patients with AAA, but endovascular management can be challenging in the setting of NF1. Surgeons should be ready to convert to open surgery if the patient displays persistent signs of bleeding or structural changes related to connective tissue disorders like NF1. |
topic |
Aneurysm Left colic artery Left hemicolectomy Neurofibromatosis type 1 von Recklinghausen disease |
url |
http://link.springer.com/article/10.1186/s40792-019-0570-4 |
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