A Case of Contained Rupture of the Common Iliac Artery with Idiopathic Retroperitoneal Fibrosis: Efficacy of Surgical Treatment and Immunosuppressive Therapy at 2-Year Follow-Up

Ryo Yokota; Shun-Ichiro Sakamoto; Tomohiro Murata; Atsushi Hiromoto; Takako Yamaguchi; Kenji Suzuki; Michiko Kobayashi; Shoko Kure; Mitsuhiro Takeno; Yosuke Ishii

doi:10.3400/avd.cr.22-00120

A Case of Contained Rupture of the Common Iliac Artery with Idiopathic Retroperitoneal Fibrosis: Efficacy of Surgical Treatment and Immunosuppressive Therapy at 2-Year Follow-Up

Ann Vasc Dis. 2023 Mar 25;16(1):95-99. doi: 10.3400/avd.cr.22-00120.

Affiliations

¹ Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan.
² Department of Integrated Diagnostic Pathology, Nippon Medical School Musashi-kosugi Hospital, Kawasaki, Kanagawa, Japan.
³ Department of Allergy and Rheumatology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan.
⁴ Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan.

Abstract

Rupture of inflammatory aortic aneurysm associated with retroperitoneal fibrosis (RF) is rare. We report a 62-year-old man with an inflammatory abdominal aortic aneurysm (IAAA) complicated with idiopathic RF, resulting in a contained rupture of the common iliac artery. The patient also presented with mild renal insufficiency due to urethral obstruction and left hydronephrosis. Surgical procedures including graft replacement and ureterolysis relieved the symptoms. Postoperative immunosuppressive treatment using corticosteroid and methotrexate successfully maintained clinical remission without signs of recurrence of RF and IAAA at the 2-year follow-up.

Keywords: inflammatory aortic aneurysm; retroperitoneal fibrosis; rupture.