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Rare Rupture of Small 4.3 cm Abdominal Aortic Aneurysm
Seth T Beeson1, Justin D Faulkner1, Dale D Coffey1
1Department of Surgery, Novant Health New Hanover Regional Medical Center, Wilmington, NC, USA.
The American Surgeon
|May 27, 2023
Summary
Rupture of small abdominal aortic aneurysms (AAAs) is rare but possible, even in asymptomatic cases. Prompt recognition and endovascular repair offer safe management for ruptured small AAAs.
Area of Science:
- Vascular Surgery
- Aortic Aneurysm Research
- Critical Care Medicine
Background:
- Abdominal aortic aneurysm (AAA) rupture is a life-threatening complication.
- Rupture risk strongly correlates with aneurysm size; rupture of AAAs <5 cm is exceedingly rare.
- COVID-19 pneumonia can present with symptoms mimicking AAA complications.
Observation:
- A case report of an asymptomatic 4.3 cm AAA rupture in a patient hospitalized with COVID-19 pneumonia.
- The patient presented with acute abdominal pain during hospitalization.
- The rupture occurred despite the aneurysm being smaller than the typical threshold for high rupture risk.
Findings:
- Successful endovascular management of a ruptured small AAA.
- Demonstrates that small AAAs can rupture unexpectedly, even when asymptomatic.
- Highlights the importance of considering AAA rupture in patients with acute abdominal pain, regardless of size.
Implications:
- Small AAAs should be considered in the differential diagnosis for acute abdominal or back pain, particularly in hospitalized patients.
- Early recognition of ruptured small AAA allows for timely and safe endovascular intervention.
- This case expands the understanding of AAA rupture risk factors and clinical presentations.
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