[A successful case report of ruptured abdominal aortic aneurysm with isolated left-sided inferior vena cava]

A 68-year-old man was admitted to our hospital because of shock. CT scan revealed ruptured abdominal aortic aneurysm (AAA) with isolated left-sided inferior vena cava (L-IVC). After emergent laparotomy, maintaining blood pressure stable, we clamped the aorta at the level of the supra-celiac region. An AAA (8.5cm in diameter) leaking from the posterior wall with a retroperitoneal hematoma was found, and L-IVC pressed by AAA was identified. The AAA was dissected with caution so as not to injure L-IVC and replaced with a woven Dacron bifurcated graft. The postoperative course was uneventful. The embryonic development and clinical significance of this rare anomaly are discussed. This is the first successful case in the Japanese literature by our survey.