A case of abdominal aortic aneurysm presenting as symptomatic disseminated intravascular coagulation treated with endovascular aneurysm repair and postoperative administration of Nafamostat mesylate

Shinichi Tanaka; Takahiro Ohmine

doi:10.1186/s40792-024-01926-6

A case of abdominal aortic aneurysm presenting as symptomatic disseminated intravascular coagulation treated with endovascular aneurysm repair and postoperative administration of Nafamostat mesylate

Surg Case Rep. 2024 May 16;10(1):124. doi: 10.1186/s40792-024-01926-6.

Authors

Shinichi Tanaka¹, Takahiro Ohmine²

Affiliations

¹ Department of Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, 1-9-6 Sendamachi, Naka-Ku, Hiroshima, 730-8619, Japan. fjhkn396@yahoo.co.jp.
² Department of Surgery, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, 1-9-6 Sendamachi, Naka-Ku, Hiroshima, 730-8619, Japan.

Abstract

Background: Cases of abdominal aortic aneurysm discovered as purpura on the extremities with disseminated intravascular coagulation (DIC) are rare. The number of currently established strategies for the control of DIC with aortic aneurysm is limited.

Case presentation: An 85-year-old woman was referred to the hematology department because of purpura on her shoulder and thigh. Enhanced fibrinolytic-type DIC was diagnosed by a blood test. Enhanced computed tomography (CT) revealed 60-mm abdominal aortic and 42-mm right common iliac aneurysms. We performed endovascular aneurysm repair (EVAR) and coiling of the right internal iliac artery with postoperative administration of Nafamostat mesylate. The patient promptly recovered from DIC, and the purpura gradually disappeared.

Conclusions: We safely performed EVAR with postoperative administration of Nafamostat mesylate for an abdominal aortic aneurysms that presented as symptomatic DIC.

Keywords: Abdominal aortic aneurysm (AAA); Disseminated intravascular coagulation (DIC); Endovascular aneurysm repair (EVAR).