Infections of the aorta

Imminent rupture of infected aortic aneurysm presenting as lower back pain in an older patient

“…Correct and early medical examination and treatment are essential because IAAA is characterized by a faster rate of enlargement 8 and a higher frequency of rupture due to its multifocal nature 9 , in comparison to abdominal aortic aneurysm (AAA). However, while AAA is often accompanied by severe symptoms, such as abdominal pain, impaired consciousness, and abnormal blood pressure, most cases of IAAA rupture are confined to the retroperitoneum, and rupture into the abdominal cavity is extremely rare 10 .…”

“…Therefore, physicians and spine surgeons should be aware of the possibility of IAAA when the patient complains of persistent back pain even after the administration of treatment for symptomatic relief. According to reports by various authors, rupture or impending rupture of an AAA should be suspected when (1) the patient is a middle-aged or older male with a history of an abdominal mass; (2) the pain is severe, with a definite onset time and a component of lateral abdominal pain; (3) there is no tenderness in the lumbar spine or surrounding soft tissues and no neurological symptoms; (4) the iliopsoas muscle shadow is abnormal on radiography; and (5) a beating mass is detected in the abdomen 9 . Palpation of the abdominal mass is recommended in patients with atypical lower back pain 9 .…”