Chronic contained rupture of an abdominal aortic aneurysm with vertebral erosion

Lai, Chih-Cheng; Tan, Che-Kim; Chu, Tung-Wei; Ding, Liang‐Wen

doi:10.1503/cmaj.070332

Cited by 20 publications

(11 citation statements)

References 1 publication

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“…A long list of other reported presentations includes lumbar vertebral erosion,30 38 39 lumbar spondylitis-like symptoms,32 40 41 left lower limb weakness or neuropathy,10 31 34 crural neuropathy,25 left psoas muscle haematoma,37 and obstructive jaundice 26. These presentations are puzzling and do not initially raise any suspicion for a ruptured aneurysm.…”

Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Assar

Zarins²

2009

Postgraduate Medical Journal

135

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Ruptured abdominal aortic aneurysm (AAA) is one of the most fatal surgical emergencies, with an overall mortality rate of 90%. Most AAAs rupture into the retroperitoneal cavity, which results in the classical triad of pain, hypotension, and a pulsatile mass. However, this triad is seen in only 25-50% of patients, and many patients with ruptured AAA are misdiagnosed. It is likely that different sites of rupture of AAA determine a variety of common and uncommon clinical presentations, the recognition of which can save many lives. This article reviews the different sites of rupture of infrarenal AAA and explores the evidence behind the various clinical presentations seen in patients with ruptured AAA.

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Section: Sites and Clinical Presentations Of Ruptured Aaamentioning

confidence: 99%

Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Assar

Zarins²

2009

Postgraduate Medical Journal

135

View full text Add to dashboard Cite

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“…However, the differential diagnosis involves pathology originating from the abdominal aorta and other retroperitoneal anatomical structures. Orthopaedic/spinal surgeons frequently need to consult with vascular surgeons in order to exclude aortic pathologies such as pseudoaneurysms or self-contained ruptured AAAs before proceeding with elective spinal surgery [5].…”

Section: Discussionmentioning

confidence: 99%

Aortic Endovascular Stent IIIb Endoleak Combined With Sealed Aneurysm Rupture Mimicking a Paravertebral Retroperitoneal Tumor

Papavasiliou¹,

Stavridis²,

Potoupnis³

et al. 2021

Cureus

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The aim of this paper is to present the unique case of a sealed ruptured abdominal aortic aneurysm (AAA) with simultaneous type IIIb endoleak of an endovascular stent, mimicking a paravertebral retroperitoneal tumor. A 75-year-old male was referred to the tumor service of our tertiary orthopaedic department suffering from intractable low back pain with an onset of six months. He had undergone repair of an infrarenal AAA with an endovascular stent 5 years ago. Imaging studies depicted a large retroperitoneal mass adjacent to L2 and L3 vertebrae. The stent's metal cage had no signs of wear or migration. The pathology report of a CT-guided core-needle biopsy he had undergone before his referral raised suspicion about possible AAA rupture. CT-angiography confirmed the existence of a ruptured AAA, accompanied by retroperitoneal blood loss and a (possibly) failed stent. The IIIb eroded stent was openly removed and a Ytype allograft was used to repair the defect. The patient reported immediate relief and was uneventfully discharged. He demised 4 years later due to reasons unrelated to the hereby reported condition. Increased awareness is warranted when dealing with anterior lumbar spine or retroperitoneal lesions. A close cooperation between a vascular and an orthopaedic/spine surgeon must always be sought.

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“…Chronic contained rupture of an abdominal aortic aneurysm is relatively rare (2.7% of operated abdominal aortic aneurysms), 1 and extremely rare at the thoracic level. Only a few case reports can be found in the literatures.…”

Section: Discussionmentioning

confidence: 99%

“…There have been some reports of abdominal vertebral erosion caused by chronic contained rupture of an abdominal aortic aneurysm. [1][2][3][4][5] For the thoracic part however, there have been fewer case reports of thoracic vertebral erosion caused by a thoracic aortic aneurysm. [6][7][8] We describe a case of large thoracoabdominal aortic aneurysm with a maximum diameter of 80 mm at the thoracic level, which was complicated by thoracic 6th and 7th vertebral erosion.…”

Section: Introductionmentioning

confidence: 99%

Chronic contained rupture of aortic aneurysm with thoracic vertebral erosion

Matsunaga

Nogami

Higuchi

et al. 2014

Asian Cardiovasc Thorac Ann

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A 66-year-old man was transferred to our hospital with the diagnosis of a large thoracoabdominal aneurysm. Computed tomography showed thoracic vertebral erosion, suggesting a chronic contained rupture. He was hemodynamically stable with no neurological complication preoperatively. He underwent successful surgical replacement of the descending aorta. During surgery, the 6th and 7th thoracic vertebral bones adjacent to the thoracic aneurysm were found to be eroded. The postoperative course was uneventful.

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Chronic contained rupture of an abdominal aortic aneurysm with vertebral erosion

Abstract: What is your call? Clinical vistas briefs Computed tomography scan of the abdomen of a 67-year-old man with a 6-month history of low-back pain. See page 996 for diagnosis.

Cited by 20 publications

References 1 publication

Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations

Aortic Endovascular Stent IIIb Endoleak Combined With Sealed Aneurysm Rupture Mimicking a Paravertebral Retroperitoneal Tumor

Chronic contained rupture of aortic aneurysm with thoracic vertebral erosion

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