Chronic Contained Rupture of an Abdominal Aortic Aneurysm Presenting as a Grynfeltt Lumbar Hernia. A Case Report

Dobbeleir, J; Fourneau, Inge; Maleux, Geert; Daenens, Kim; Vandekerkhof, Jos; Nevelsteen, André

doi:10.1080/00015458.2007.11680067

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…The psoas muscle and vertebral body resist the pressure of retroperitoneal hemorrhage [6] as was the case in our patient. In addition, a small aneurysmal tear, fibrosis and organized thrombus are considered to be the mechanism for chronic AAA rupture [7]. CTA is a very sensitive diagnostic imag-ing for complete and sovereign diagnosis of chronic AAA retroperitoneal rupture.…”

Section: Discussionmentioning

confidence: 99%

Lower back pain - silent symptom of chronic infrarenal abdominal aneurysm rupture

et al. 2016

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We present a patient having had the lower back pain for 4 months, which had been recognized and treated as lumbar ischialgia but which was eventually diagnosed to be chronic infrarenal abdominal aortic aneurysm rupture by computed tomography angiography. The surgical intervention was successful and the patient was discharged from hospital after 6 days without any clinical complications. Preoperative imaging by computed tomography angiography of ruptured abdominal aortic aneurysm is highly sensitive for detection of several specific signs for rupture. This condition leads to urgent vascular surgery.

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Section: Discussionmentioning

confidence: 99%

Lower back pain - silent symptom of chronic infrarenal abdominal aneurysm rupture

et al. 2016

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“…DU has been found sufficient for initial detection of CCRs, but can fall short when a rupture is too small or posterior to detect. 3 A partially encapsulated retroperitoneal hematoma, periaortic hypoechoic or anechoic regions are initial indicators detected by gray-scale imaging. 16 Application of color flow and spectral Doppler settings has been found useful in detection of leaks or extravasations with appropriate scale and gain settings.…”

Section: Discussionmentioning

confidence: 99%

“…17 If active flow is noted coursing from the aneurysm to the hematoma, the rupture is considered to be acute and life threatening, whereas the absence of flow is suggestive of a “sealed” or chronic rupture. 3,18…”

Section: Discussionmentioning

confidence: 99%

“…Compared with acute ruptures, which generally manifest as sudden flank/abdominal pain and hypotension, chronic contained ruptures (CCR) are subtle and may go undetected for months or in some cases years. 1–3 Symptomatology of a CCR has been documented as chronic lower back pain, intermittent abdominal pain in the left lower quadrant (LQ), groin pain, weight loss, and lower extremity weakness or neuropathy. 2–8 Although temporarily encapsulated, a CCR is a ruptured aneurysm which may progress to a free rupture, warranting immediate surgical intervention upon diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Duplex Ultrasound Detection of a Chronic Contained Rupture of an Abdominal Aortic Aneurysm

Warren

Roberts

2016

Journal for Vascular Ultrasound

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Introduction Chronic containment of a ruptured abdominal aortic aneurysm (AAA) is a rare clinical phenomenon that is often accompanied by abstract symptomatology, delayed diagnosis, and treatment. We describe a case of chronic contained rupture (CCR) in a hemodynamically stable and asymptomatic patient detected by duplex ultrasound (DU). Patient Description A 71-year-old white male presented to our medical facility to establish cardiac care for newly diagnosed pleural effusion and bilateral lower extremity edema. Physical examination revealed prominent abdominal aortic pulsations. An abdominal DU was ordered to evaluate for an AAA. Methods An abdominal DU examination was performed utilizing a Philips iU22 xMATRIX Ultrasound System equipped with a C5–1 MHz PureWave transducer. The aorta, common iliac and external iliac arteries were evaluated with gray scale, color, and spectral Doppler applications. Imaging Results The DU confirmed the presence of a 5.6 cm × 5.7 cm infrarenal AAA. The lumen was noted to have irregularities and multiple avascular hypoechoic lesions that were reproducible in multiple imaging planes. Computed tomography (CT) confirmed the presence of the 4.8-cm aneurysm accompanied by a 5.6 cm × 4.0 cm multi-lobular fluid collection extending into the mesentery. Active extravasations were not visualized during contrast administration; nevertheless, the appearance of the irregularity was suspicious of aneurysm leak resulting in evolving hematoma. The CCR was treated with a bifurcated intraluminal stent graft. Conclusion This case describes an extremely rare rupture complication that may be present during routine evaluation of the abdominal aorta. Because of its rarity in case presentation, standardized protocol for detection and sonographic presentation remain undocumented.

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“…In our case, neurological evaluation was normal. Paraparesis [10], paraplegia [11], low back pain [14], and lumbar hernia [15] were reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Multidetector Computed Tomography Angiography Findings of Chronic-Contained Thoracoabdominal Aortic Aneurysm Rupture with Severe Thoracal Vertebral Body Erosion

Yüksekkaya

Köner

Çelikyay

et al. 2013

Case Reports in Radiology

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Chronic-contained aortic aneurysm rupture with vertebral erosion is a rare entity with fatal complications. Multidetector computed tomography (CT) angiography is an important diagnostic method for the evaluation of the aortic aneurysms, their complications, and also the relationship between aneurysm and branching vessels and adjacent structures. We present the multidetector CT angiography findings of a 62-year-old patient with chronic-contained thoracoabdominal aortic aneurysm rupture causing severe vertebral body erosion.

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Chronic Contained Rupture of an Abdominal Aortic Aneurysm Presenting as a Grynfeltt Lumbar Hernia. A Case Report

Cited by 8 publications

References 8 publications

Lower back pain - silent symptom of chronic infrarenal abdominal aneurysm rupture

Lower back pain - silent symptom of chronic infrarenal abdominal aneurysm rupture

Duplex Ultrasound Detection of a Chronic Contained Rupture of an Abdominal Aortic Aneurysm

Multidetector Computed Tomography Angiography Findings of Chronic-Contained Thoracoabdominal Aortic Aneurysm Rupture with Severe Thoracal Vertebral Body Erosion

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