[Effective thromboexclusion for repeating bleeding tendency caused by dissecting aneurysm: a case report]

A 75-year-old woman developed general fatigue and left chest pain in October 1986, and Chest CT showed DeBakey IIIb dissecting aneurysm. During the next 8 months, she repeated abdominal pain, tarry stool and subcutaneous hemorrhage for three times and after an angiography large hematoma at puncture site appeared. The laboratory data showed the decrease in platelet and fibrinogen and the increase in FDP every time when she developed the symptoms. Because this bleeding tendency was thought to be the "local DIC" caused by dissecting aneurysm, we performed thromboexclusion on July 27, 1987. Immediately after the operation, 60 packs of platelet and 3 g of fibrinogen was transfused, then laboratory data remarkably improved and bleeding tendency disappeared. The patient died 12 days after the operation of sudden ventricular tachycardia. At autopsy, precise cause of death was not determined, but the purpose of thromboexclusion seemed to be achieved, because good thrombus formation was observed in the descending aorta and the graft was patent.