Unusual presentations of anastomotic aneurysms: the need for continued vigilance

Two patients are reported in whom lethal abdominal aortic anastomotic aneurysms developed. The first presented as exsanguinating hematuria of unknown cause 1 1/2 years after graft replacement of a dissecting aortic aneurysm while the other presented with fever due to an infected aortic graft two years after correction of aortoiliac occlusive disease. The difficult management of these cases was further complicated by delay in diagnosis due primarily to their unusual presentations. Unusual presentations of graft complications must be suspected in all patients with vascular graft prostheses and postoperative localized or systemic complaints.