Unusual presentations of abdominal aortic aneurysms

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine
• Medical Case Studies

Background:

• Abdominal aortic aneurysms (AAAs) are typically diagnosed and treated electively.
• Rarely, AAAs can present with unusual complications that mimic other conditions.
• Understanding these rare presentations is crucial for timely diagnosis and management.

Purpose of the Study:

• To detail two rare cases of abdominal aortic aneurysms.
• To review the literature on these specific rare presentations.
• To explore the underlying pathophysiology of these uncommon clinical scenarios.

Main Methods:

• Retrospective review of 100 consecutive patients undergoing surgical repair of abdominal aortic aneurysms.
• Detailed case history presentation of two patients with rare findings.
• Comprehensive literature review of similar documented cases.

Main Results:

• One patient presented with concomitant AAA rupture and thrombosis, leading to lower extremity paraplegia and anesthesia.
• Another patient had a stable AAA with documented disseminated intravascular coagulation (DIC), which resolved with heparin and subsequent surgical repair.
• Both described presentations are exceedingly rare, with fewer than five documented instances in the surgical literature.

Conclusions:

• These cases underscore the diverse and sometimes rare clinical manifestations of abdominal aortic aneurysms.
• Disseminated intravascular coagulation associated with a stable AAA can be effectively managed with anticoagulation and surgical intervention.
• Further research into the pathophysiology of these rare AAA complications is warranted.