부산대학교 도서관

case 1：55-year-old female with hemorrhagic shock due to ruptured inferior pancreaticoduodenal artery aneurysm underwent decompressive laparotomy for abdominal compartment syndrome （ACS） after transarterial embolization （TAE）. There was no active bleeding at initial laparotomy, but active mesenteric hemorrhage and non-occlusive mesenteric ischemia （NOMI） were identified at relaparotomy. She passed away due to NOMI on the 2nd hospital day despite complete hemostatic mesenteric suture.case 2：53-year-old male with hemorrhagic shock due to ruptured middle colic artery branch aneurysm underwent decompressive laparotomy for ACS after TAE. There was active mesenteric hemorrhage at initial laparotomy and he underwent colectomy with hemostatic mesenteric suture. The anastomosis was achieved on the following day and he was discharged on the 14th hospital day.discussion：It is evident that decompressive laparotomy for ACS is useful; however the procedure increase the risk of rebleeding of critically ill patients with ruptured visceral artery aneurysm even though the hemostasis is achieved with TAE.