Surgical Management of Chronic Contained Rupture of an Abdominal Aortic Aneurysm Presenting as Right Lower Extremity Pain
- VernacularTitle:右下肢痛を呈した腹部大動脈瘤chronic contained ruptureの1例
- Author:
Noburo OHASHI
1
;
Daisuke KOMATSU
1
;
Shuji CHINO
1
;
Toru MIKOSHIBA
1
;
Haruki TANAKA
1
;
Hajime ICHIMURA
1
;
Toshihito GOMIBUCHI
1
;
Megumi FUKE
1
;
Yuko WADA
1
;
Tatsuichiro SETO
1
Author Information
- Keywords: abdominal aortic aneurysm; chronic contained rupture; lower extremity pain
- From:Japanese Journal of Cardiovascular Surgery 2024;53(6):354-357
- CountryJapan
- Language:Japanese
- Abstract: Chronic contained rupture of an abdominal aortic aneurysm （AAA） is a rare condition that can present with atypical symptoms, making diagnosis challenging. We report a case of chronic contained rupture of an AAA with vertebral destruction presenting as right lower extremity pain. A 78-year-old man with a history of mitral valve replacement and pyogenic spondylitis （L2-L3） presented with a two-month history of low back pain and a four-day history of right lower extremity pain and numbness. Computed tomography revealed a 61 mm diameter ruptured AAA with an irregular margin. Magnetic resonance imaging demonstrated vertebral destruction at L4-L5. The patient underwent open surgical repair with a rifampicin-soaked graft and debridement. Intraoperatively, a large defect was found at the posterior aspect of the aneurysm, exposing the destroyed vertebral bodies. Postoperatively, the patient required spinal immobilization for persistent neurological symptoms, which improved and the patient was discharged on postoperative day 55.
