Journal «Angiology and Vascular Surgery» • 

1999 • VOLUME 5 • №3

CHRONIC CONTAINED RUPTURE OF AN ABDOMINAL AORTIC ANEURYSM

Lazar Davidovic, Slobodan Lotina, Ilijas Cinara, Djordje Zdravkovic, Tijana Simic, Predrag Djoric, Svetozar Putnik
Institute for Cardiovascular Diseases, Center for MRI of the Serbian Clinical Center,
Belgrade, Yugoslavia

Treatments of five cases with chronic contained rupture of abdominal aortic aneurysms are presented in this paper. There were 3 male and 2 female patients, with average age of 62 years. Four of them had an infrarenal abdominal aortic aneurysms, and one thoracoabdominal aneurysm Crawford type IV. They all had a previously knowledge of abdominal aortic aneurysm, and initial sympioms persisted or months before admission. The typical signs of the rupture were absent in all cases. One «saccular» aneurysm, two «pseudoaneurysms», two compression and dislocation of the right renal artery and inferior vein cava, were found angiographicaly. In one case retrograde urography demonstrated compression on the right ureter. In two cases, magnetic resonance imaging showed organized retroperitoneal hemathoma, while in two cases Duplex ultrasonography and CT scan, described this hemathoma as a «lobular mass». The mean time interval between initial symptoms and the operation, was 38.2 (21-90) days. In all cases, a chronic rupture with old organized retroperitoneal hemathoma was found during the operation. The tube aortic graft was used in two, while bifurcated in three of cases. All patients recovered very well. In all cases, the grafts are patent after the mean follow up period of 2.9 (1-5) years. The peri-operative mortality rate in case of chronic contained aneurysm rupture, is lower compared with a classic form, however also requires urgent operation.

KEY WORDS: Abdominal aortic aneurysms, chronic rupture.

P. 64-70

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