Diagnosis and perioperative management of ruptured AAA mimicking symptomatic groin hernia

Klein, Holger Jan; Becker, Daniel G.; Rančić, Zoran

doi:10.1016/j.ijscr.2015.11.020

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…10 Ruptured abdominal aortic aneurysms (AAA) has been described to mimic symptomatic groin hernias and testicular pains. [11][12][13] This case highlights the importance of considering aortoiliac aneurysms as differentials for abdominal and groin pain or masses. Thorough exploration of the history and careful examination will help flag these diagnoses in our clinical assessment.…”

Section: Discussionmentioning

confidence: 89%

Ruptured internal iliac artery aneurysm masquerading as an inguinal hernia

Tay¹

2021

MOJCR

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Internal iliac artery aneurysms are rare, representing less than 2% of all aneurysms. Nonetheless, the mortality is high at up to 60% when ruptured. Ruptured internal iliac artery aneurysms commonly present with overt abdominal pain and systemic instability. They can also present with symptoms of pelvic organ dysfunction, such as urinary retention or obstipation. This report describes the first case of a ruptured internal iliac artery (IIA) aneurysm masquerading as a reducible inguinal hernia. It was diagnosed on a Computed Tomography scan, which showed a large contained ruptured right IIA aneurysm with extension of haemorrhage through the hernia sac. He underwent an endovascular procedure to exclude the aneurysm that was uncomplicated, and he had an uneventful recovery. It highlights the importance of considering IIA aneurysms as differentials for abdominal masses, groin lumps or vague symptoms of pelvic organ dysfunction. Thorough exploration of the history and careful examination will help flag these diagnoses in our clinical assessment.

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Section: Discussionmentioning

confidence: 89%

Ruptured internal iliac artery aneurysm masquerading as an inguinal hernia

Tay¹

2021

MOJCR

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Ruptured abdominal aneurysm disguised as an incarcerated inguinal hernia

Colpaert

Willaert

Molhem

2017

Acta Chirurgica Belgica

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An incarcerated inguinal hernia is a textbook example of a basic and straightforward diagnosis. In rare cases, an incarcerated hernia may be a symptom of more complex underlying pathology. In this case report a patient with a ruptured abdominal aortic aneurysm presented with an incarcerated left inguinal hernia. Only two other cases have been reported with a stable patient at initial presentation. The diagnosis was suspected when blood seeping next to the internal inguinal ring was detected, and an urgent ultrasound in the operating room confirmed the diagnosis. Whether or not patients with an inguinal hernia are more at risk for an AAA remains unclear.

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Internal Hernia Incarceration Mimicking Impending Rupture of an Abdominal Aortic Aneurysm

et al. 2021

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A 68-year-old man visited a family physician with a complaint of epigastric pain lasting several hours. Computed tomography revealed an abdominal aortic aneurysm that was 60 mm in length and a small amount of ascites, resulting in a tentative diagnosis of impending rupture of the abdominal aortic aneurysm. The patient was referred to our hospital and underwent emergency surgery. Intraoperative findings ruled out rupture and inflammatory changes in the abdominal aortic aneurysm. We observed the abdominal cavity and detected an internal hernia. The 15-cm-long ileum was incarcerated by an abnormal cord between the vesicorectal fossa and peritoneum. The cord was dissected to release the internal hernia. Intestinal peristalsis and pulsation of the marginal artery were maintained, allowing us to avoid intestinal resection. The patient reported that his epigastric pain disappeared soon after surgery. On the 24th postoperative day, the patient underwent abdominal aortic replacement. Our case suggests that internal hernia incarceration is an important differential diagnosis of impending rupture of an abdominal aortic aneurysm, even in cases with no history of laparotomy.

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Diagnosis and perioperative management of ruptured AAA mimicking symptomatic groin hernia

Abstract: HighlightsRAAA presenting as symptomatic groin hernia has poor survival.CTA for diagnosis and preoperative planning is strongly recommended.Hypotensive haemostasis lowers mortality.Coinciding inguinal hernias should not be repaired at the same time.

Cited by 3 publications

References 16 publications

Ruptured internal iliac artery aneurysm masquerading as an inguinal hernia

Ruptured internal iliac artery aneurysm masquerading as an inguinal hernia

Ruptured abdominal aneurysm disguised as an incarcerated inguinal hernia

Internal Hernia Incarceration Mimicking Impending Rupture of an Abdominal Aortic Aneurysm

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