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.

Introduction. Upper extremity venous aneurysms and aneurysms of the neck are rare, unlike the lower extremity venous aneurysms. Only a few cases of upper extremity venous aneurysms have been described in the literature. The aim of the study was to find the best way to treat upper extremity venous aneurysms and the aneurysms of the neck region. Case Report. A 40-year-old female patient reported to the Emergency Center due to the swelling in the supraclavicular region. Color Doppler ultrasonography was performed and a saccular subclavian aneurysm was found, at the junction with the internal jugular vein, with signs of rupture presenting with locoregional hematoma spillage measuring 19 x 13 mm. Complete laboratory tests were performed, followed by computed tomography phlebography, where a partially thrombosed aneurysm was described in the angle between the internal jugular vein and subclavian vein, with a maximum diameter of 25 mm. The patient was hospitalized and treated conservatively. Six days after the onset of symptoms, magnetic resonance phlebography was performed, which did not show the previously described aneurysm of the left venous angle. Three months after the onset of symptoms, a control magnetic resonance phlebography was performed, which showed an aneurysm in the region of the junction of the left internal jugular vein and subclavian vein again, with a maximum diameter of 20 x 13 mm. Conclusion. Clinical examination and color Doppler ultrasound should certainly be the first-line of diagnosis, while magnetic resonance phlebography and computed tomography phlebography are the gold standard for aneurysm monitoring. Asymptomatic aneurysms and aneurysms with mild symptoms are best treated conservatively.

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Introduction. Abdominal aortic aneurysm diameter is one of the most important parameters in the diagnostic and therapeutic algorithm for aneurysm follow-up. Currently, two therapeutic modalities are used: open surgery and endovascular aortic repair. The aim of this study is to analyze the impact of the maximum transverse diameter of the abdominal aortic aneurysm on the incidence of general and specific complications. Material and Methods. The retrospective study included 75 patients with infrarenal abdominal aortic aneurysm who underwent endovascular aortic repair in the period from July 2008 to January 2020. The patients were divided into two groups: group A with an abdominal aortic aneurysm size ? 5.9 cm, and group B with an abdominal aortic aneurysm size ? 6.0 cm. Results. A total of 41.3% of patients presented with a maximum transverse aneurysm diameter of ? 5.9 cm, and 58.7% of patients had ? 6.0 cm. Of comorbid diseases, chronic obstructive pulmonary disease was more prevalent in patients with a large abdominal aortic aneurysm (group A 25.8%; group B 59.1%). None of the other comorbidities showed a statistically significant difference between the two groups of patients. Early complications were present in a total of 14.7% of patients, of which 12.9% of patients with a small and 15.9% with a large abdominal aortic aneurysm. Late complications occurred in a total of 18.7% of patients, in 9.7% of patients with a small and 25% of patients with a large abdominal aortic aneurysm. Conclusion. Patients with abdominal aortic aneurysms with a maximum transverse diameter of 6 cm and larger, present with a higher rate of late postoperative complications, increase in aneurysmal sac on control multislice computed tomography angiography, and have a worse prognosis compared to patients with smaller abdominal aortic aneurysms.