Top

Abdominal Radiology

Published in:

01-02-2010

Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature

Authors: S. Apter, U. Rimon, E. Konen, Z. Erlich, L. Guranda, M. Amitai, O. Portnoy, G. Gayer, M. Hertz

Published in: Abdominal Radiology | Issue 1/2010

Abstract

Purpose

To assess the CT features of sealed rupture of abdominal aortic aneurysm.

Patients and methods

We reviewed the CT scans of six index cases obtained over a 3 year period with a sealed rupture of an abdominal aortic aneurysm and those reported in the literature over a 21 year period. CT scans were reviewed for aneurysm size, the presence of a draped aorta and adjacent vertebral erosion. A group of consecutive patients with non-ruptured abdominal aortic aneurysm, referred for endovascular aneurysm repair during the same 3 year period constituted the control group.

Results

In the study group of 31 patients the mean size of the aneurysm was 6.24 ± 2.01 cm, compared to 6.01 ± 0.99 cm in the control group, without statistically significant difference (t = 0.75, df = 97, P = 0.46). A draped aorta was detected in all patients with a sealed rupture. Vertebral erosion was present in all our six, but mentioned in only 14 of the cases reported.

Conclusion

A sealed rupture of an abdominal aortic aneurysm can occur in relatively small aneurysms. A draped aorta and adjacent vertebral erosion are characteristic CT signs of such a rupture.

Siegel CL, Cohan RH (1994) CT of abdominal aortic aneurysms. AJR 163:17–29PubMed

Bhalla S, Menias CO, Heiken JP (2003) CT of acute abdominal aortic disorders. RCNA 41:1153–1169CrossRef

Schwartz SA, Taljanovic MS, Smyth S, O`Brien MJ, Rogers LF (2007) CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms. AJR 188:W57–W62CrossRefPubMed

Rakita D, Newatia A, Hines JJ, Siegel DN, Friedman B (2007) Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. RadioGraphics 27:497–507CrossRefPubMed

Choplin RH, Karstaedt N, Wolfman NT (1982) Ruptured abdominal aortic aneurysm simulating pyogenic vertebral spondylitis. AJR 138:748–750PubMed

Grevitt MP, Fagg PS, Mulholland RC (1996) Chronic contained rupture of an aortic aneurysm mimicking infective spondylitis. Eur Spine J 5:128–130CrossRefPubMed

Sakai T, Katoh S, Sairyo K, et al. (2007) Extension of contained rupture of an abdominal aortic aneurysm into a lumbar intervertebral disc. J Neurosurg Spine 7:221–226CrossRefPubMed

Kapoor V, Kanal E, Fukui MB (2001) Vertebral mass resulting from a chronic-contained rupture of an abdominal aortic aneurysm repair graft. AJNR 22:1775–1777PubMed

Gandini R, Chiocchi M, Maresca L, et al. (2008) Chronic contained rupture of an abdominal aortic aneurysm: from diagnosis to endovascular resolution. Cardiovasc Intervent Radiol 31(Suppl 2):S62–S66CrossRefPubMed

10.

Nonami Y, Okazaki Y, Yamashiro T, Ogoshi S (1995) Chronic contained rupture of an abdominal aortic aneurysm. Cardiovasc Surg 3:227–229CrossRefPubMed

11.

Ubukata H, Kasuga T, Motohashi G, Katano M, Tabuchi T (2005) Spinal destruction induced by chronic contained rupture of an abdominal aortic aneurysm: report of a case. Surg Today 35:411–414CrossRefPubMed

12.

Horowitz M, Gayer G, Itzchak Y, Rapoport MJ (2006) To biopsy or not to biopsy: an 82-year-old patient with a retroperitoneal mass and severe low back pain. Eur J Intern Med 17:55–56CrossRefPubMed

13.

Jones CS, Reilly MK, Dalsing MC, Glover JL (1986) Chronic contained rupture of abdominal aortic aneurysms. Arch Surg 121:542–546PubMed

14.

Sterpetti AV, Blair EA, Schultz RD, et al. (1990) Sealed rupture of abdominal aortic aneurysms. J Vasc Surg 11:430–435CrossRefPubMed

15.

Bonamigo TP, Becker M, Weber ELSW, et al. (2006) Outcome after surgical repair of sealed rupture abdominal aortic aneurysms: a case-control study. Clinics 61(1):29–34CrossRefPubMed

16.

Halliday CE, Al-Kutoubi A (1996) Draped aorta: CT sign of contained leak of aortic aneurysms. Radiology 199:41–43PubMed

17.

Higgins R, Peitzman AB, Reidy M, et al. (1988) Chronic contained rupture of an abdominal aortic aneurysm presenting as a lower extremity neuropathy. Ann Emerg Med 17:284–287CrossRefPubMed

18.

Rosenthal D, Clark ND, Stanton PE Jr, Lamis PA (1986) “Chronic-contained” ruptured abdominal aortic aneurysm: is it real? J Cardiovasc Surg (Torino) 27:723–724

19.

Nakagawa Y, Masuda M, Shiihara H, et al. (1990) A chronic contained rupture of an abdominal aortic aneurysm complicated with severe back pain. Ann Vasc Surg 4:189–192CrossRefPubMed

20.

Galessiere PF, Downs AR, Greenberg HM (1994) Chronic, contained rupture of aortic aneurysm associated with vertebral erosion. Can J Surg 37:23–28PubMed

21.

Aune S, Trippestad A (1995) Chronic contained rupture of an abdominal aortic aneurysm complicated by infection and femoral neuropathy. Eur J Surg 161:613–614PubMed

22.

Ohtake H, Mukai K, Watanabe Y (1996) Twice sealed-rupture of a small abdominal aortic aneurysm with unusual computed tomography findings. A case report. J Cardiovasc Surg (Torino) 37(3):249–250

23.

Villegas-Cabello O, Silier J (1999) Asymptomatic rupture of an aortoiliac aneurysm. Tex Heart Inst J 26:219–222PubMed

24.

Edrees WK, Lee B (2000) A rare case of radiculopathy in an elderly man. Postgrad Med J 76:586, 591–592

25.

Dorrucci V, Dusi R, Cordiano C (2001) Contained rupture of an abdominal aortic aneurysm presenting as obstructive jaundice: report of a case. Surg Today 31:331–332CrossRefPubMed

26.

Defraigne JO, Sakalihasan N, Lavigne JP, Van Damme H, Limet R (2001) Chronic rupture of abdominal aortic aneurysm manifesting as crural neuropathy. Ann Vasc Surg 15:405–411CrossRefPubMed

27.

Szpinda M, Flisin`ski P, Molski S (2001) ‘Chronic-contained’ rupture abdominal aortic and right common iliac artery aneurysms. Case Rep Clin Pract Rev 2:112–115

28.

Ando M, Gary T, Yokoyama H, Satokawa H (2003) CT features of chronic contained rupture of an abdominal aortic aneurysm. Ann Thorac Cardiovasc Surg 9:274–278PubMed

29.

Saiki M, Urata Y, Katoh I, Hamasaki T (2006) Chronic contained rupture of an abdominal aortic aneurysm with vertebral erosion: report of a case. Ann Thorac Cardiovasc Surg 12:300–302PubMed

30.

Bansal M, Bansal M, Thukral BB, Malik A (2006) Contained rupture of thoracoabdominal aortic aneurysm presenting as a back mass. J Thorac Imaging 21:219–221CrossRefPubMed

31.

Obinata D, Takenobu Y, Sakuma T, et al. (2007) Chronic contained rupture of an abdominal aortic aneurysm mimicking a retroperitoneal tumor. Hinyokika Kiyo 53:397–399PubMed

32.

Szilagyi DE, Smith RF, Macksood AJ, Whitcomb JG (1961) Expanding and ruptured abdominal aortic aneurysms. Problems of diagnosis and treatment. Arch Surg 83:395–408PubMed

33.

Al-Koteesh J, Masannat Y, James NVM, Sharaf U (2005) Chronic contained rupture of abdominal aortic aneurysm presenting with longstanding back pain. SMJ 50:122–123

34.

Ramasamy PR, Fox D, Narendra G, Carnie L, Watura R (2001) Chronic contained leak of abdominal aortic aneurysm presenting as lumbar neuropathy. J R Coll Surg Edinb 46:307–309PubMed

35.

Maclaurin WAM, Hawkins SP (1997) The “draped aorta” in leaking aneurysms: aneurysm size correlation should have been provided. Radiology 203:578PubMed

36.

Darling RC (1970) Ruptured arteriosclerotic abdominal aortic aneurysms: a pathologic and clinical study. Am J Surg 119:397–401CrossRefPubMed

37.

Siegel CL, Cohan RH, Korobkin M, et al. (1994) Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR 163:1123–1129PubMed

38.

Macedo TA, Stanson AW, Oderich GS, et al. (2004) Infected aortic aneurysms: imaging findings. Radiology 231:250–257CrossRefPubMed

Title: Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature
Authors: S. Apter
U. Rimon
E. Konen
Z. Erlich
L. Guranda
M. Amitai
O. Portnoy
G. Gayer
M. Hertz
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: Abdominal Radiology / Issue 1/2010
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-008-9488-1

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature

Abstract

Purpose

Patients and methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2010

Evaluation of entire gastric fundic and esophageal varices secondary to posthepatitic cirrhosis: portal venography using 64-row MDCT

Double-contrast magnetic resonance imaging of the small and large bowel: effectiveness in the evaluation of inflammatory bowel disease

Multiple bilateral renal oncocytoms in a known case of tuberous sclerosis: a case report

Portrait of a polyp: the CTC dilemma

Whole body imaging in the abdominal cancer patient: pitfalls of PET-CT

Endoleaks after endovascular repair of abdominal aortic aneurysm: value of CEUS

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page