Japanese Journal of Cardiovascular Surgery
Online ISSN : 1883-4108
Print ISSN : 0285-1474
ISSN-L : 0285-1474
Case Reports [Aortic Disease]
Surgical Management of Chronic Contained Rupture of an Abdominal Aortic Aneurysm Presenting as Right Lower Extremity Pain
Noburo OhashiDaisuke KomatsuShuji ChinoToru MikoshibaHaruki TanakaHajime IchimuraToshihito GomibuchiMegumi FukeYuko WadaTatsuichiro Seto
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2024 Volume 53 Issue 6 Pages 354-357

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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.

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© 2024 The Japanese Society for Cardiovascular Surgery
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