Very late rupture of a post-traumatic abdominal aortic pseudoaneurysm

Abstract

Post-traumatic abdominal aortic pseudoaneurysms remain a rare yet severe complication of aortic injuries and may present many years later. Clinical presentations vary, from the traditional aneurysmal symptoms of abdominal and/or back pain with or without a pulsatile mass, to a fatal rupture. We present the case of a man aged 42 years, with a history of blunt abdominal trauma 14 years ago, presenting with symptoms of non-specific lower abdominal pain and a recent history of straining due to constipation. Clinical examination revealed umbilical bruising, in keeping with Cullen's sign, and extensive postsacral bruising. This case highlights some of the atypical manifestations of aneurysmal rupture and the importance of early recognition and management.

Huge Pseudoaneurysm at the Aortic Bifurcation Misdiagnosed as a Mesenchymal Tumor: A Case Report

“…However, the large size (9.2 cm) and high-pressure location of the lesion, along with the possibility of a delayed rupture, which would have proven fatal in a patient of this age, led us to believe that aggressive management was indicated. A similar case of aortic PA at the aortic bifurcation reported a delayed rupture after 14 years, although this seemed to be due to a lack of imaging evidence of PA immediately after traumatic injury [20].…”

Contained abdominal aortic rupture secondary to follicular lymphoma invasion

“… 5 Although the typical diagnosis of acute ruptured aneurysms and pseudoaneurysms of the aorta involve a triad of chest and/or back pain, a pulsatile abdominal mass, and hypotension, it is not uncommon for a patient to lack all the features of this triad. 6 The more commonly associated etiologies include trauma, infection, and inflammation. Rarely, pseudoaneurysms can be caused by chronic inflammation involved with malignancy.…”