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(searched for: Chronic Ruptured Abdominal Aortic Aneurysm)
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, , Carsten Arnoldussen, Roel Janssen
Published: 1 September 2020
Annals of Vascular Surgery, Volume 70, pp 568.e5-568.e11;

The publisher has not yet granted permission to display this abstract.
Palmier Mickael, Rouer Martin, Pochulu Bruno, Monnot Antoine,
Published: 11 February 2019
Annals of Vascular Surgery, Volume 58, pp 378.e1-378.e3;

The publisher has not yet granted permission to display this abstract.
, Fadia Salman, Veronica Picone, Maurizio Maiorano, Enrico Maria Centritto, Massimo Massetti
Published: 1 January 2022
SAGE Open Medical Case Reports, Volume 10;

Chronic-contained rupture of an aortic aneurysm is a rare subset of ruptured aneurysms. The presentation is unusual, and the diagnosis is frequently delayed. Here, we describe a case of contained rupture of abdominal aortic aneurysm that presented with signs and symptoms of femoral neuropathy. Clinical and radiological findings were initially misinterpreted. The correct diagnosis was formulated belatedly, causing a progressively increased risk of fatal events. Surgical aortic repair was performed and the postoperative course was uneventful. In conclusion, in the presence of a retroperitoneal mass, a diagnosis of chronic-contained rupture of an abdominal aortic aneurysm should be considered.
M. S. John Pathy
Published: 16 December 2005
The publisher has not yet granted permission to display this abstract.
, , F. Vanhoenacker, J. De Leersnyde
Published: 1 January 2012
Acta chirurgica Belgica, Volume 112, pp 382-385;

Case report : We report a 69-year-old Caucasian male who presented with irreversible ischemia to the left foot. CT-scan showed, besides occlusion of both superficial femoral arteries, a chronic contained rupture of an abdominal aortic aneurysm. The aneurysm was excluded with a stent graft placed through a femoral approach in a semi-urgent procedure. CT-scans at 1, 3 and 6 months demonstrated continued exclusion of the aneurysm. Chronic ruptures are a rare but important subset of ruptured abdominal aortic aneurysms. CT-scan with contrast enhancement is the gold standard diagnosing technique. Treatment consists of prompt surgical intervention with endovascular repair being increasingly used as an alternative to an open surgical approach.
Vibhu Kapoor, Emanuel Kanal, Melanie B. Fukui
Published: 1 October 2001
American Journal of Neuroradiology, Volume 22, pp 1775-1777

Summary: We describe a case of a 63-year-old man with chronic-contained rupture of an abdominal aortic aneurysm at the site of prior graft repair of the aneurysm. Initially misinterpreted as osteomyelitis on the basis of CT findings, this chronic-contained rupture of the abdominal aorta eroding the vertebrae was preoperatively diagnosed at MR imaging and confirmed at surgery. A conventional angiogram failed to show the pseudoaneurysm. Owing to a major difference in the management of a contained aortic aneurysm rupture versus that for osteomyelitis, MR imaging with CT or MR angiography is recommended before any operative or invasive procedure.
Sherif Y. Shalaby, Trenton R. Foster, Michael R. Hall, Kirstyn E. Brownson, Penny Vasilas, Daniel G. Federman, Hamid R. Mojibian,
Published: 1 February 2016
Journal: JAMA Surgery
JAMA Surgery, Volume 151, pp 147-153;

Abdominal aortic aneurysm (AAA) is common, with a prevalence of 3% in people older than 60 years.1 The pathogenesis of AAA is associated with extracellular matrix remodeling, vascular smooth muscle cell apoptosis and necrosis, oxidative stress, and infiltration of inflammatory cells, often associated with connective tissue disease, resulting in aortic wall degeneration.2-6 Several studies have suggested that chronic inflammation in the aortic wall may be a consequence of a dysregulated and persistent autoimmune inflammatory response against aortic wall antigens.7,8
, Susumu Ohwada, Kenzo Okauchi, Yutaka Hasegawa
Published: 7 September 2021
Clinical Case Reports, Volume 9;

The publisher has not yet granted permission to display this abstract.
Noriyasu Morikage, Kohji Dairaku, Yuji Fujita, Shuji Toyota, Kohichi Yoshimura, Kentaro Fujioka, Nobuya Zempo, Kensuke Esato
Japanese Journal of Cardiovascular Surgery, Volume 25, pp 71-73;

症例は53歳, 男性. 1994年5月ごろより腰痛が出現し, 原因不明のまま近医で経過観察されていた. 同年7月中旬ごろより疼痛は増強し, 精査加療目的で当科紹介入院となった. 腹部CT, MRI検査では腹部大動脈瘤およびその背側の後腹膜腔に血腫が広がり, L3, L4椎体の破壊がみられた. 血圧低下や進行する貧血もなく全身状態は極めて安定していた. 椎体破壊は短期間に生じていたが, 血腫の圧迫によると思われる典型的な画像所見を呈しており, 腹部大動脈瘤の chronic contained rupture と診断した. 手術は瘤壁を切開したところ大動脈後壁に約2cm大の破裂孔があり, 後腹膜腔に血塊が充満し, その背側に破壊された椎体がみられた. 腎動脈分岐下大動脈をY型人工血管にて置換した. 術後経過は良好で, 腰痛も消失した.
Y. Nonami, Y. Okazaki, T. Yamashiro, S. Ogoshi
Published: 1 April 1995
Cardiovascular Surgery, Volume 3, pp 227-229;

The publisher has not yet granted permission to display this abstract.
Tarek Sraieb, Youssef Ben Ameur, Syrine Bougamra, Selma Longo, Nabil Ben Romdhane, Jamel Manaa, Mohamed Lotfi Slimane
Published: 1 November 2004
La Tunisie medicale, Volume 82, pp 1052-5

Chronic contained rupture of abdominal aortic aneurysm is a rare event which can cause diagnostic difficulties. It can present as a chronic back pain and the delayed diagnosis and delayed surgical repair may compromise the final results. The outcome of urgent repair of a chronic contained leak is equivalent to that of elective aneurysm repair. We report a case of contained rupture of a small abdominal aortic aneurysm with delayed diagnosis, evaluated by computed tomography showing a beginning erosion of the lumbar vertebral body. The patient was operated on within 24 hours on admission with uneventful surgical outcome.
, M. Alonso Pérez, E. Adeba Vallina
Revista Española de Cirugía Ortopédica y Traumatología, Volume 56, pp 478-481;

Chronic low back bain is a common cause of medical consultation, and is often associated with degenerative vetebral disease. Despite this, we must not forget other diseases even in those cases where the imaging tests may suggest chronic degenerative changes in the lumbar spine, including the possible presence of an abdominal aortic aneurysm with a contained rupture must be ruled out due to its prognostic and therapeutic implications. We present 5 cases of chronic low back pain associated with serious lytic lesions in the vertebral body due to chronic rupture of an abdominal aortic aneurysm.
Kenji Ariizumi, Ryoichi Hashimoto, Hideki Kobashiri, Shigeaki Kaga
Japanese Journal of Cardiovascular Surgery, Volume 27, pp 114-117;

Christopher S. Jones, M. Kathleen Reilly, Michael C. Dalsing, John L. Glover
Published: 1 May 1986
Archives of Surgery, Volume 121, pp 542-546;

• Anecdotal reports of chronic contained rupture of abdominal aortic aneurysms exist. Their existence and implications have been largely ignored. From March 1984 to March 1985, 24 patients required repair of an infrarenal abdominal aortic aneurysm. Four patients underwent emergent repair. The remaining 20 patients were evaluated with computed tomography electively. Seven patients (35%) were demonstrated to have a rupture of the aneurysm and a retroperitoneal hematoma on the computed tomographic scan. All of the patients had histories of back or flank pain; five patients continued to complain of mild pain on admission. In no case was shock, impending shock, or a decrease in the hemoglobin level present on admission. All patients were operated on within 24 hours of evaluation. At operation, rupture was noted with organized hematoma outside the aorta contained in a pseudoaneurysmal wall of retroperitoneal connective tissue. There was no intraperitoneal blood. There was no operative mortality and survival was 100% at six months. The CT scan evaluation had identified a subgroup of patients with aneurysms associated with chronic contained rupture. (Arch Surg 1986;121:542-546)
Hisayoshi Osawa, Satoru Sugimoto, Kouji Maekawa, Noriyasu Watanabe, Toshiaki Tanaka
Japanese Journal of Cardiovascular Surgery, Volume 32, pp 145-147;

症例は72歳,男性.平成12年6月腰痛を自覚,近医受診したところCT検査にて腹部大動脈瘤を指摘され当院へ紹介された.CT検査で下大静脈を圧排する後腹膜血腫が存在し腹部大動脈瘤の慢性破裂と診断し,平成12年9月27日Y字型人工血管で腹部大動脈瘤を置換した.手術所見で腎動脈下の瘤右側後壁寄りに10×20mm大の破裂孔と多量の陳旧性血腫を認めsealed ruptureと診断した.自験例はJonesらが提唱した“chronic contained rupture”の概念に相当するものと思われた.
, Shingo Ohuchi, Takeshi Arai,
Journal of Vascular Surgery Cases, Innovations and Techniques, Volume 7, pp 280-282;

The publisher has not yet granted permission to display this abstract.
, Elizabeth A. Blair, Richard D. Schultz, Richard J. Feldhaus, Silvestro Cisternino, Paul Chasan
Published: 1 March 1990
Journal of Vascular Surgery, Volume 11, pp 430-435;

Sealed rupture of abdominal aortic aneurysms, even if uncommon, deserves particular attention for the possibility of misdiagnosis and for the deleterious effects of such a misdiagnosis. Sixteen patients (mean age 72 years; range 65 to 84 years) with chronic sealed rupture of abdominal aortic aneurysms are reported. Two patients had acute rupture of the aneurysm, and at operation chronic contained rupture was found along with the recent hemorrhage. One patient died after surgery. The remaining patients underwent successful resection with long-term survival and regression of symptoms. Consideration of sealed abdominal aortic aneurysm rupture should be included when examining elderly patients with history of unexplained back pain or femoral neuropathy. Computed tomography is a useful aid in the diagnosis of sealed rupture. Ultrasonography is less accurate; in three patients ultrasonography failed to diagnose the presence of the rupture.
, Tympa Aliki, Kalinis Aris, Vasilopoulos Ioannis,
Published: 1 October 2011
Annals of Vascular Surgery, Volume 25, pp 981.e1-981.e5;

Although the mortality rate after abdominal aortic aneurysm rupture approximates 90% despite the urgent management, a few cases of chronic rupture and delayed repair have been reported in the world literature; anatomic and hemodynamic reasons occasionally allow for the fortunate course of these patients. We report in this article the case of 76-year-old man with a ruptured abdominal aortic aneurysm who was transferred to our facility 4 weeks after his initial hospitalization in a district institution and who finally had a successful open repair.
Hideyuki Ubukata, Teruhiko Kasuga, Gyou Motohashi, Motonobu Katano, Takafumi Tabuchi
Published: 23 April 2005
Journal: Surgery Today
Surgery Today, Volume 35, pp 411-414;

We report a case of spinal destruction caused by chronic contained rupture of an abdominal aortic aneurysm (AAA). The patient was a 73-year-old man who had undergone coronary artery bypass grafting, sigmoidectomy for colon cancer, and axillofemoral bypass with AAA resection within months of each other, 3 years earlier. Abdominal computed tomography and magnetic resonance imaging showed destruction of the 12th thoracic and 1st lumbar vertebrae. The possibility of a metastatic spine tumor prompted us to consult the orthopedic surgeons, who recommended a spinal percutaneous needle aspiration biopsy. However, the cardiovascular surgeons diagnosed chronic contained rupture of an inflammatory AAA. The patient gradually improved with antimicrobial treatment, but died of disseminated intravascular coagulation the following year. The definitive diagnosis was confirmed by autopsy. We report this case for its educational value, considering the serious consequences that might have occurred had we attempted to biopsy the lesion.
, Dhafer Kamal
Annals of vascular diseases, Volume 8, pp 113-115;

A 63-year-old Caucasian male presented with a 4-month history of low back pain associated with bilateral intermittent claudication. A contrast enhanced CT scan demonstrated a 4 cm abdominal aortic aneurysm (AAA), along with severe bilateral aorto-iliac disease, a right psoas collection, and extensive vertebral erosion. An MRI of the lumbar spine suggested spondylodiscitis at L4-L5. After an unsuccessful and prolonged course of antibiotics, a decision was ultimately made to repair the aneurysm and bypass the aorto-iliac disease. Intra-operatively, a chronic contained rupture (CCR) involving the posterior aortic wall was encountered and repaired with an aorto-bifemoral bypass graft.
, Dimitrios M. Mavros, Evaggelos A. Pappas, Stefanos K. Atmatzidis, Dimitrios K. Papadimitriou
Published: 1 October 2012
Annals of Vascular Surgery, Volume 26, pp 1011.e7-1011.e10;

Chronic contained rupture (CCR) of an abdominal aortic aneurysm is a rare condition, and differential diagnosis might be difficult. We present a clinical case of a hemodynamically stable octogenarian who presented with intermittent pain in the left lower abdomen. The patient had a history of diverticulitis, and 6 years ago, he had undergone endovascular abdominal aortic aneurysm repair (EVAR) with a Talent bifurcated prosthesis. Additionally, 20 days before his admission to our hospital, he had undergone a secondary iliac limb extension for treatment of post-EVAR rupture. On admission, abdominal plain radiography identified suprarenal fixation fracture as a possible reason for CCR, but computed tomographic angiography failed to confirm any endoleak or "active" bleeding and rupture. The patient received medication treatment for possible diverticulitis and was kept under close monitoring for suspected failure of recently performed secondary endovascular procedure and CCR. A day later, the abdominal pain symptoms worsened, and a new computed tomographic angiography confirmed the suspected CCR. The patient was treated successfully by "open" repair using a Y prosthesis. To our knowledge, this is the first reported case of post-EVAR CCR due to suprarenal fixation fatigue fracture. Lifelong post-EVAR follow-up with high level of both clinical and imaging diagnostic accuracy is essential for the early recognition and proper treatment of EVAR pitfalls.
Masaki Ando, Tsuguo Igari, , Hirono Satokawa
Published: 1 August 2003
Annals of Thoracic and Cardiovascular Surgery, Volume 9

Four cases among the 149 patients who required repair of an infrarenal abdominal aortic aneurysm (AAA) during the last five years, were chronic contained rupture. The first symptom at onset was back pain and physical examination revealed the patients to be in no acute distress. The sites of rupture were posterior in all cases. They were operated through an extraperitoneal approach. There was no operative mortality and all survived. The CT features, (1) discontinuity of the rim of calcification in the true aneurysm wall, (2) well defined soft tissue density adjacent to the aorta, (3) the concealed psoas muscle and the displaced viscera depending on the size of the lesion, and (4) no appearance of contrast material in the hematoma in some cases, led to the correct diagnosis of contained rupture.
, J.F. Blanco Blanco, D. Pescador Hernández, F.J. García García
Published: 10 December 2014
International Journal of Surgery Case Reports, Volume 6, pp 296-299;

Low back pain is a common cause of medical consultation, and usually supposes a non-malignant prognostic.
Takao Ohki, ,
International Journal of Angiology, Volume 27, pp 081-091;

The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms. However, its indication has expanded along with the improvement of techniques and devices, and currently, it has become possible to treat pararenal aortic aneurysms and Crawford type 4 thoracoabdominal aortic aneurysm (TAAA) using the off-the-shelf devices. Additionally, custom-made devices allow for the treatment of arch or more extensive TAAAs. Endovascular treatment is applied not only to aneurysms but also to acute/chronic dissections. However, long-term outcomes are still unclear. This article provides an overview of available devices and the results of endovascular treatment for various aortic pathologies.
C Robert DeArmas, Harry S. Gilbert
Clinical nuclear medicine, Volume 20, pp 925-926;

A 72-year-old woman with respiratory failure and chronic obstructive lung disease had abdominal pain and gastrointestinal bleeding. An ultrasound demonstrated an abdominal aortic aneurysm and during performance of a Tc-99m RBC gastrointestinal bleeding study, rupture of the aneurysm was observed. She was taken to the operating room where a large, contained retroperitoneal hematoma was found in association with a ruptured abdominal aortic aneurysm. This was repaired with a graft and the patient underwent colectomy for Ischemic bowel as well. The patient died the next day.
Yavuz Yörükoğlu, Mustafa Zengin, Eşref Paşaoğlu, Kemal Nazliel, Ergun Salman, Ertan Yücel
Published: 1 April 1993
Journal: Vascular surgery
Vascular surgery, Volume 27, pp 212-218;

Behçet's disease, originally described as a triad of orogenital ulcerations and uveitis, is a chronic, multisystem disorder involving the skin, mucous mem branes, gastrointestinal tract, eyes, joints, central nervous system, and blood vessels. Vascular manifestations of Behçet's disease (vasculo-Behçet's disease) consists of venous and arterial forms. The arterial form is rare but carries a grave prognosis. The authors present a case of Behçet's disease that manifested itself with a rupture of an abdominal aortic aneurysm. The outcome, although successful in this case, poses a prognostic dilemma for the surgical team in volved. The world literature in respect to complications and prognosis of vascu lar reconstruction in Behçet's disease is reviewed and discussed.
V Dorrucci, G F Veraldi, R Dusi, G Rombolà
Published: 2 August 2000
Annali italiani di chirurgia, Volume 71

Rupture of an abdominal aortic aneurysm often presents with an abdominal pain, hypotension and a pulsatile abdominal mass. In the last years same clinical reports describe patients with less apparent clinical signs who were found later in their evaluation to have a contained rupture of an abdominal aortic aneurysm. The diagnosis may be delayed by consideration of other disease causing similar symptoms (herniated disc, renal colic). In these patients with confusing abdominal symptoms CT scan provides a rapid and noninvasive diagnosis. We report three cases of contained rupture of an abdominal aortic aneurysm evaluated by computed tomography with different clinical presentation: back pain for erosion into the lumbar vertebral bodies, lower extremity neuropathy and obstructive jaundice. All patients were operated on within 24 hours on admission; there was no operative mortality and survival was 100% at one year.
Mirela Jukovic, Tijana Kokovic, Dragan Nikolic, Dalibor Ilic, Viktor Till
Published: 1 January 2016
Journal: Medical review
Medical review, Volume 69, pp 115-117;

Introduction. The rupture of infrarenal abdominal aortic aneurysm is a surgical emergency condition with a high rate of mortality before the patients arrive at hospital. The signs and symptoms of abdominal aortic aneurysm rupture into the retroperitoneal cavity are pulsatile mass, abdominal pain, hypotension and shock, but sometimes silent symptoms also hide a dangerous and life threatening condition, such as chronic aneurysm rupture of abdominal aorta into the retroperitoneal cavity. Case Report. We present a patient having had the lower back pain for 4 months, which had been recognized and treated as lumbar ischialgia but which was eventually diagnosed to be chronic infrarenal abdominal aortic aneurysm rupture by computed tomography angiography. The surgical intervention was successful and the patient was discharged from hospital after 6 days without any clinical complications. Preoperative imaging by computed tomography angiography of ruptured abdominal aortic aneurysm is highly sensitive for detection of several specific signs for rupture. This condition leads to urgent vascular surgery.
Yasutsugu Nakagawa, Masahisa Masuda, Hideshige Shiihara, Hitoshi Furukawa, Naoki Hayashida, Hitoshi Kasegawa, Hiroyuki Abe, Katsuji Okui
Published: 1 March 1990
Annals of Vascular Surgery, Volume 4, pp 189-192;

Chronic contained rupture of an abdominal aortic aneurysm is an uncommon occurrence with the aneurysms usually small-to-moderate in size. Diagnosis may be difficult because patients present with both atypical and chronic symptoms. Pressure erosion of the lumbar spine is presumably a highly significant associated disorder, but an enhanced computed tomographic scan is the most reliable method for the correct diagnosis. We report on a 46-year-old man who developed severe back pain which was initially thought to result from spinal disease. Retrospective review of computed tomographic scans taken two years before admission revealed the beginning of the leakage of the aneurysm. Remarkably, the patient remained stable two years after the rupture.
Shaafiya Ashraf, , Shivani Sharma, Dawood Iqbal Wani
Galician Medical Journal, Volume 26;

There is a diagnostic and therapeutic dilemma in cases of chronic contained rupture of abdominal aortic aneurysm, as the symptoms can be more subtle including dull back pain, and thus lacking the typical features of rupture. The objective of this research was to introduce a case report emphasizing the need to relate the low back pain with atypical radiological appearances of entities, as aortic abdominal aneurysms, capable to compromise the patients’ clinical diagnosis, prognosis and treatment.
Louise A. Anderson
Journal of Cardiovascular Nursing, Volume 15, pp 1-14;

Abdominal aortic aneurysm is a chronic dilation of the aorta with a natural history toward enlargement and rupture. Its pathogenesis is believed to be multifactorial and complex. Clinical presentation may be asymptomatic, symptomatic, or as rupture. Elective surgery by open transperitoneal or retroperitoneal approach is the most common repair intervention. However, placing an endoluminal stent graft within the aneurysm is currently being evaluated as an alternative to open repair. Nursing care of the patient with abdominal aortic aneurysm involves intensive care skills as well as a foundation in chronic illness management. This article presents information on pathogenesis, natural history, clinical presentation, surgical interventions, and postoperative complications.
M. Garb
Published: 1 May 1989
Australasian radiology, Volume 33, pp 154-156;

There is no place for investigative CT scans in patients who have the classical triad of abdominal aortic aneurysm rupture, namely excruciating abdominal pain or backache, a pulsatile mass and hypotension. These patients require immediate surgery. However, in the absence of this triad, CT scans play an important role in the diagnosis of abdominal aortic aneurysm rupture. The CT scan findings will dictate whether the patient requires immediate surgery as in the case of acute rupture, or, whether the surgery can be delayed up to 24 hours to allow for stabilisation and hydration, as in the case of subacute and chronic rupture.
, Yukio Ichikawa, Hirokazu Kajiwara
Published: 1 December 2008
Asian Cardiovascular and Thoracic Annals, Volume 16;

Computed tomography in a 74-year-old man with intermittent claudication revealed an abdominal aortic aneurysm, retroperitoneal hematoma, vertebral erosion, and total aortic occlusion. Surgery was delayed for 9 months after definitive diagnosis of contained rupture of the aortic aneurysm to allow treatment for ischemic heart disease and cardiac failure. After interposing a Y-shaped woven Dacron graft, the intermittent claudication was alleviated. The postoperative course was uneventful.
, Martin P. Laird, John E. Frawley
Published: 4 March 2008
Vascular and Endovascular Surgery, Volume 42, pp 391-393;

In this article, a novel technique for the treatment of ruptured abdominal aortic aneurysm secondary to proximal type 1 endoleak as a result of progressive neck dilatation after endovascular aneurysm repair is reported. A 74-year-old man with multiple comorbidities including severe ischemic heart disease, congestive cardiac failure, and chronic renal failure presented with a ruptured abdominal aortic aneurysm. He had an infrarenal endovascular aneurysm repair performed in 1999 and had subsequently developed a proximal type 1 endoleak. At open laparotomy, the placement of 4 nylon ties around the infrarenal aneurysm neck to refashion a seal and exclude the sac from systemic pressurization effectively treated the rupture. In the high-risk patient, ruptured proximal type 1 endoleak can be successfully treated with external banding avoiding the potential morbidity seen with the aortic clamping and blood loss of open conversion.
, Ruth Fuente, Irene García-Saiz, Alvaro Revilla, Miguel Martín-Pedrosa, Carlos Vaquero
Published: 1 June 2016
Cirugía Española, Volume 94, pp 339-345;

To determine the usefulness of mortality risk scores for the endovascular treatment of ruptured abdominal aortic aneurysms.Retrospective study of 61 patients undergoing endovascular repair between 2009 and 2014. Preoperative variables and in-hospital mortality were collected. The Hardman, GAS, Vancouver and ERAS scales were calculated.In-hospital mortality was 45.9%. The univariate predictors obtained were age, male sex, hypertension, smoking, chronic obstructive pulmonary disease, systolic blood pressure 80 years)+0.701 (if systolic blood pressure<80mmHg)+0.598 (if heart rate<70 beats/min); obtained an area under the curve of 0.95.Age, systolic pressure and heart rate, are predictors of hospital mortality of patients treated with endovascular repair of ruptured abdominal aortic aneurysms. Applying the scale proposed in this study, in combination with GAS, Vancouver and ERAS scales, allows the detection of patients who would not benefit from endovascular treatment.
Enrico Ascher, Marcel Scheinman, Patrick DePIPPO, William Yorkovich
Published: 1 November 1999
Annals of Vascular Surgery, Volume 13, pp 613-617;

During a recent 30-month period, we repaired 10 ruptured abdominal aortic aneurysms (RAAA) at our institution. To evaluate the survival, postoperative morbidity, and financial impact of treating RAAA, we compared these patients with 10 randomly selected patients undergoing elective AAA (EAAA). Both groups were comparable for age, gender, and incidence of diabetes, hypertension, coronary artery disease, chronic obstructive pulmonary disease (COPD), and renal failure. Although we have noted a dramatic increase in survival for RAAA (90%), the morbidity continues to be unacceptably high (60%). Efforts should be made toward better detection of AAA prior to rupture as well as development of strategies to minimize or prevent these major complications. Potential average savings accrued from one patient undergoing EAAA repair rather than RAAA repair ($93,139. 21) can be used to perform screening abdominal ultrasound tests in patients at increased risk of having an AAA.
D Rosenthal, M D Clark, P E Stanton, P A Lamis
Published: 1 November 1986
The Journal of Cardiovascular Surgery, Volume 27

Rupture of an abdominal aortic aneurysm is readily diagnosed when the triad of abdominal or back pain, shock and a pulsatile abdominal mass are present. Clinical diagnosis can be difficult, however, when patients present with chronic pain and an aneurysm which is not readily palpable. In these patients with confusing abdominal symptoms, CT scan provides a rapid, noninvasive diagnosis. The acute leaking AAA has been documented, but only rarely. This report identifies two patients who ruptured an aortic aneurysm several "months" prior to operation--a "contained chronic" rupture.
, Ying Huang, Jay Mandrekar, Philip P. Goodney, Gustavo S. Oderich, Manju Kalra, Thomas C. Bower, Jack L. Cronenwett, Peter Gloviczki
Published: 11 August 2017
Journal of Vascular Surgery, Volume 67, pp 151-156.e3;

The publisher has not yet granted permission to display this abstract.
, Ngoc-Thanh Le, Quoc-Hung Doan
Asian Cardiovascular and Thoracic Annals, Volume 27, pp 33-35;

Erosion of vertebral bodies by an abdominal aortic aneurysm is extremely rare. Chronic contained rupture can cause difficulties in diagnosis because there are many clinical presentations: back pain, sciatic pain, or an expansive abdominal mass. Computed tomography is the gold-standard diagnostic tool. We report the case of a 49-year-old man who suffered from back pain because of a chronic ruptured aortic aneurysm.
, Omer Karatoprak, , , Mehmet Tezer, Azmi Hamzaoglu
Published: 30 April 2008
The Spine Journal, Volume 8, pp 394-396;

The publisher has not yet granted permission to display this abstract.
, Fabiano Cardoso, Artur Fernandes
Published: 31 January 2016
by EduRad
Journal of radiology case reports, Volume 10, pp 27-34;

This report describes a case of chronically ruptured abdominal aortic aneurysm contained within the lumbar vertebral bodies that presented with dull abdominal pain. Sudden, massive hemorrhage is an uncommon, yet well-known complication of an untreated abdominal aortic aneurysm. In addition, misleading clinical and radiological findings present difficult diagnostic challenges in such cases. This report emphasizes the findings obtained with multidetector computed tomography and delineates the differentiation of this condition from similar pathologies.
, Vivek Virmani, Manish Modi, Naveen Kalra, Niranjan Khandelwal
Published: 1 November 2014
Annals of Vascular Surgery, Volume 28, pp 1931.e1-1931.e4;

Chronic contained rupture of the aorta is a rare condition that may present with varied patient symptomatology. We present a case of contained rupture of an abdominal aortic aneurysm causing vertebral erosion in an elderly male patient who had chronic backache and presented to the emergency services with a recently developed throbbing epigastric mass. Early use of computed tomography enabled prompt diagnosis and the condition was managed by endovascular stenting. The clinical and imaging findings of this potentially fatal condition are described, awareness of which is important to the physicians, orthopedicians, surgeons, and radiologists.
Sean T. Walker, , , Christopher J. Vargo
Journal of computer assisted tomography, Volume 41, pp 839-842;

Chronic contained rupture of an abdominal aortic aneurysm with vertebral body erosion most commonly presents with symptoms of low back pain. Although not well known, vertebral body erosion or destruction may be seen in up to 25% of patients with sealed or contained rupture of an abdominal aortic aneurysm. This appearance on cross-sectional imaging may mimic a malignant or infectious process. Although these cases can present a diagnostic challenge, published cases of chronic contained rupture of an abdominal aortic aneurysm with vertebral body erosion demonstrate clinical and imaging similarities that, when recognized, can assist in diagnosis.
M L Gavant, J E Salazar, J Ellis
Published: 1 May 1986
Journal of computer assisted tomography, Volume 10

Computed tomography in patients with a ruptured abdominal aortic aneurysm usually demonstrates the aneurysm with blood in the posterior para- and perirenal spaces. Hemorrhage into the adjacent perirenal space occurs because the aorta, via the renal vascular pedicle, is in continuum with this compartment. The kidney is commonly displaced but not compromised functionally. We report a case of an asymptomatic chronic intrarenal rupture of a focal aortic aneurysm that presented as a mass in a nonfunctioning kidney.
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