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Chronic Contained Abdominal Aortic Aneurysm Rupture Mimicking Vertebral Spondylodiscitis: A Case Report

Abdulrahman Alshafei1, Dhafer Kamal1

  • 1Department of Vascular Surgery, Bahrain Defense Force Hospital, Royal Medical Services, Kingdom of Bahrain.

Annals of Vascular Diseases
|July 2, 2015
PubMed

Insights

A patient with low back pain and intermittent claudication had an abdominal aortic aneurysm (AAA) and aorto-iliac disease. Surgical repair with an aorto-bifemoral bypass graft successfully treated the chronic contained rupture (CCR).

Area of Science:

  • Vascular Surgery
  • Infectious Disease
  • Radiology

Background:

  • A 63-year-old male presented with chronic low back pain and bilateral intermittent claudication.
  • Imaging revealed a 4 cm abdominal aortic aneurysm (AAA), severe aorto-iliac disease, psoas collection, and vertebral erosion suggestive of spondylodiscitis.

Observation:

  • Lumbar spine MRI suggested spondylodiscitis at L4-L5.
  • Initial antibiotic treatment for suspected infection was unsuccessful.

Findings:

  • A chronic contained rupture (CCR) of the posterior aortic wall was identified during surgery.
  • The patient underwent successful repair with an aorto-bifemoral bypass graft.

Implications:

  • This case highlights the importance of considering AAA in patients with back pain and claudication.
  • Surgical intervention is crucial for managing complex AAA with associated spinal pathology and infection.
  • Successful aorto-bifemoral bypass grafting can effectively treat AAA and aorto-iliac occlusive disease.

Keywords:
abdominal aortic aneurysm (AAA)chronic contained rupture (CCR)vertebral erosion

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