[Cruralgia heralding the rupture of an abdominal aneurysm - reminder through a clinical case]

Area of Science:

• Vascular Surgery
• Diagnostic Imaging
• Emergency Medicine

Background:

• Abdominal aortic aneurysms (AAAs) are common, particularly in men, with numerous risk factors.
• AAAs often remain asymptomatic until rupture, with symptoms varying by location.
• Ruptured AAAs pose a significant mortality risk if not promptly diagnosed and treated.

Observation:

• A 71-year-old female presented with symptoms suggestive of left cruralgia (leg pain), accompanied by fever and shivering.
• Initial symptoms were misleading, potentially masking a more severe underlying condition.
• Clinical and anamnestic data strongly indicated a possible abdominal aortic rupture despite the seemingly localized leg pain.

Findings:

• Abdominal computed tomography (CT) scan revealed a ruptured infrarenal aortic aneurysm.
• The patient underwent successful, uncomplicated endovascular aneurysm repair (EVAR) with a stent graft.
• The infrarenal location of the aneurysm was confirmed.

Implications:

• This case underscores the importance of a high index of suspicion for abdominal aortic aneurysm rupture, even with atypical presentations like isolated leg pain.
• Early diagnosis through advanced imaging (CT scan) is critical for timely intervention.
• Successful endovascular repair offers a viable treatment option for ruptured AAAs, improving patient outcomes.