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Abdominal pain and hemoperitoneum: sole presenting symptoms for "leaking AAA" after endovascular repair
R A White1, C E Donayre, I Walot
1Division of Surgery, Harbor-UCLA Medical Center, Torrance, California 90509-9823, USA. raw@ucla.edu
Purpose:
To describe an unusual presentation of impending aortic endograft rupture and successful endovascular rescue.
Case Report:
A 77-year-old man with an enlarging aortic aneurysm was treated with a Talent bifurcated endoprosthesis; a moderate endoleak that appeared to be related to either proximal or distal fixation sites was noted in the body of the aneurysm. The patient was observed for 1 month, and repeat imaging demonstrated persistent endoleak without major increase in the aneurysm diameter. Another examination was scheduled for 3 months hence, but, 2 months later, the patient presented with abdominal pain and a hemoperitoneum. A proximal extension cuff resolved the leak and led to resolution of the hemoperitoneum.
Conclusions:
A leaking aneurysm can be repaired using endovascular techniques in patients with an existing endograft. The need for frequent imaging surveillance of patients with endoleak is underscored.