Late Rupture of a Thrombosed Aortic Abdominal Aneurysm – a Case Report

Abstract

Introduction: Severe back pain caused by a thrombosed and ruptured aortic abdominal aneurysm can imitate a lumbar disc herniation. Case presentation: We present the case of a 72-year-old diabetic patient with chronic atrial fibrillation, who had been experiencing high-intensity low back pain and claudication in the last year prior to his presentation. After experiencing a minor trauma, a lumbar MRI examination was performed, which revealed a retroperitoneal tumoral mass compressing and eroding the L2–L4 vertebral bodies. Computed tomography angiography showed an infrarenal aortic aneurysm (3.374 × 3.765 cm) which appeared to have ruptured and thrombosed. The question arising was when did the rupture occur, how massive was the damage, and how suitable for reconstruction was the aortic wall below the origin of the renal arteries. An open repair was scheduled and performed. The intraoperative finding was ruptured aneurysm of the thrombosed infra-abdominal aorta. The thrombosis extended along the common iliac and external iliac branches. We performed an aortobifemoral bypass using a 16 × 8 mm Dacron graft, clamping the aorta above the origin of the renal arteries. Conclusion: The unintentional diagnosis, due to a minor fall, was overall a fortunate event for this patient. Aortic aneurysms may present with lumbar pain that can be mistakenly interpreted as a spinal issue.

Impact of COVID-19 pandemic on Vascular Surgery Unit activity in Central Romania

“…The leading chronic pathologies admitted to the clinic are peripheral artery disease (PAD), chronic venous insufficiency (CVI), symptomatic carotid stenosis, and patients with end-stage chronic kidney disease for arteriovenous fistula (ESKD). The acute pathologies include acute ischemia of the upper and lower limb, arterial trauma, and ruptured aortic aneurysm ( 24 – 32 ).…”

Innovative Technical Solution Using the Renal Artery Stump after Nephrectomy as an Inflow Artery for Lower Limb Revascularization—A Case Report

“…Still, these are recommendations for managing an aneurysm with a particular diameter (over 5.5 cm) ( 13 ). AAA has a high mortality rate and may evolve toward retroperitoneal rupture, aorto-enteric fistula formation, or spontaneous thrombosis ( 14 , 15 ).…”

“…Still, these are recommendations for managing an aneurysm with a particular diameter (over 5.5 cm) (13). AAA has a high mortality rate and may evolve toward retroperitoneal rupture, aorto-enteric fistula formation, or spontaneous thrombosis (14,15). This paper aims to present an innovative surgical technique of using the remaining renal artery, after nephrectomy, as an inflow artery for the revascularization of the critical ischemic leg, in a patient presenting with an infrarenal AAA and the occlusion of the common and external right iliac artery.…”

Polytetrafluorethylene Prosthesis Interposition in Vascular Access

“…Unfortunately, the prosthetic vascular access graft was shown to be more susceptible to infection, thrombosis, and bleeding in the long term [11,12]. In vascular surgery, grafts are used for both surgical revascularization and access vascular surgery [6,[13][14][15][16][17][18][19]. Numerous studies have been performed in recent years to monitor the biocompatibility of grafts and their resistance to infection [20][21][22].…”