Contained ruptured abdominal aortic aneurysm presenting as cauda equina syndrome

Engamba, Serge A; Garaleviciene, Dovile; Baldry, Jonathan

doi:10.1136/bcr-2016-216602

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…The typical triad of acute abdominal or lumbar pain, hypotension, and shock is not present. 5 Patients with chronically contained rupture of aneurysms are hemodynamically stable and have a long history of back or loin pain with symptoms attributable to compressive or erosive effect. 6 In fact, as in this case, the rupture may occur within a contained space such as the retroperitoneum or the psoas muscle space, leading to the patient being stable at presentation and often for longer.…”

Section: Discussionmentioning

confidence: 99%

“… 6 In fact, as in this case, the rupture may occur within a contained space such as the retroperitoneum or the psoas muscle space, leading to the patient being stable at presentation and often for longer. 5 Booth and Galland 7 reported that the clinical features of contained AAA rupture are vague with back pain in 64% of cases, abdominal pain in 20%, groin pain in 14%, femoral neuropathy in 8%, sepsis in 10%, and asymptomatic in 8%. 4 The clinical presentation may masquerade as metastatic carcinoma, infectious spondylitis, retroperitoneal infection, psoas abscess, and, rarely, obstructive jaundice.…”

Section: Discussionmentioning

confidence: 99%

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Chronic abdominal aortic rupture mimicking femoral neuropathy

Modugno

Salman

Picone

et al. 2022

SAGE Open Medical Case Reports

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Chronic-contained rupture of an aortic aneurysm is a rare subset of ruptured aneurysms. The presentation is unusual, and the diagnosis is frequently delayed. Here, we describe a case of contained rupture of abdominal aortic aneurysm that presented with signs and symptoms of femoral neuropathy. Clinical and radiological findings were initially misinterpreted. The correct diagnosis was formulated belatedly, causing a progressively increased risk of fatal events. Surgical aortic repair was performed and the postoperative course was uneventful. In conclusion, in the presence of a retroperitoneal mass, a diagnosis of chronic-contained rupture of an abdominal aortic aneurysm should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Chronic abdominal aortic rupture mimicking femoral neuropathy

Modugno

Salman

Picone

et al. 2022

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…A report by Maki et al described a case of CES which occurred in the aftermath of a lumbar micro-discectomy, where the patient developed symptoms secondary to the shifting of the dural sac caused by ventral epidural venous plexus engorgement which developed as an operative complication [6]. Engamba et al reported a case in which a patient presented with CES which resulted from the rupture of an underlying aortic aneurysm [7]. In a report by Singh et al, an 11-year-old boy was determined to have CES, which resulted from an underlying spinal hydatid cyst, which was initially thought to be an intradural extramedullary benign lesion [8].…”

Section: Discussionmentioning

confidence: 99%

A Successful Outcome Despite Delayed Intervention for Cauda Equina Syndrome in a Young Patient with a Posterior Epidural Disc Extrusion

Mugge

Caras

Miller

et al. 2019

Cureus

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Epidural disc extrusion is extremely rare and may cause cauda equina syndrome. This is a surgical emergency and needs rapid decompression. Although cauda equina is commonly caused by disc herniation, this is an unusual presentation with epidural disc extrusion. We present a very rare case of Cauda Equina syndrome, resulting from an epidural disc extrusion at L3-L4 level. Patient care and progress notes were reviewed along with pre-, post-, and intra-operative radiological imaging. Here, a 19-year-old male with a past medical history of type I diabetes mellitus, fell asleep on a chair at home in an unusual position and was unable to walk on awakening. The patient developed progressive neurological deficits including bilateral foot drop along with bowel and bladder dysfunction. In addition, he experienced paresthesia and severe lower back pain unresponsive to steroids. Pre-operative magnetic resonance imaging (MRI) demonstrated a herniated disk epidurally with disc extrusion and mass effect and compression at the L3-L4 level, wrapping around the posterior aspect of the dura. A diagnosis of cauda equina syndrome was made and surgical decompression was performed. Using microsurgical technique and fluoroscopic guidance, a bilateral laminectomy of L3 was achieved with bilateral partial laminectomy of L4, with bilateral foraminotomy of L4. After removal of the lamina, a mass was immediately visualized in the posterior epidural space. Further dissection of the substance and following it posteriorly, identified the mass as a portion of the extruded disc. Post-operatively, the patient experienced rapid recovery. In conclusion, this case demonstrates that a disc extrusion can occur within the epidural space and can cause cauda equina syndrome. As this presentation is unusual, surgeons must be aware that they may encounter disc mass in unexpected locations, in a clinically delayed setting, long after the initial onset of symptoms.

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Contained ruptured abdominal aortic aneurysm presenting as cauda equina syndrome

Cited by 2 publications

References 8 publications

Chronic abdominal aortic rupture mimicking femoral neuropathy

Chronic abdominal aortic rupture mimicking femoral neuropathy

A Successful Outcome Despite Delayed Intervention for Cauda Equina Syndrome in a Young Patient with a Posterior Epidural Disc Extrusion

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