A Case Report on Improvement in Left Intercostal Pain, Dyspepsia, and Fatigue Following Thoracoabdominal Aortic Aneurysm Graft Replacement with Korean Medicine Treatment

Introduction: This case report describes a patient with severe left intercostal neuralgia, paralytic ileus, and systemic weakness following thoracoabdominal aortic aneurysm (TAAA) repair, successfully managed with integrative Korean medicine treatment.Case presentation: A 70-year-old man who underwent open surgical repair for TAAA presented with persistent post-thoracotomy pain, gastrointestinal dysfunction, marked systemic inflammation, and elevated liver enzymes. Over 25 days, the patient received herbal medicines, including <i>Bojungikki-tang-gami</i> (補中益氣湯加味), <i>Daebo-tang-gami</i> (大補湯加味), <i>Majain-hwan</i> (麻子仁丸), and <i>Oryeong-san</i> (五苓散), in combination with acupuncture, Jungseongeohyeol pharmacopuncture, and moxibustion. Following treatment, intercostal neuralgia improved, with the numeric rating scale score decreasing from 6 to 3, enabling discontinuation of analgesics. Gastrointestinal motility recovered with radiographic resolution of ileus, and Visual Analog Scale (VAS) scores for dyspepsia and systemic fatigue both decreased from 8 to 2.Conclusion: This case highlights integrative Korean medicine as a safe and effective option for managing complex postoperative complications following cardiovascular surgery.