Cor Vasa 2020, 62(3):315-318 | DOI: 10.33678/cor.2019.084

Contained rupture of an infected abdominal aneurysm eroding into the L4 vertebra in a patient after aorto-femoral reconstruction

Róbert Novotný^a, Libor Janoušek^a,b, Jaroslav Chlupáč^a,b, Karel Sutoris^a, Michal Kudla^a, Jiří Froněk^a,b,c

^a Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague

^b First Faculty of Medicine, Charles University, Prague

^c Second Faculty of Medicine, Charles University, Prague

Introduction: Chronic contained rupture of the abdominal aneurysm (AAA) eroding into the vertebrae is relatively uncommon. One of its manifestations besides pulsatile abdominal mass can be unspecific low back pain. Case presentation: A 70-year-old male patient after right aorto-femoral prosthetic bypass (RAFB) eleven years ago was referred to our center with non-specific lower back pain lasting for the past 12 hours. Computed tomography angiography (CTA) revealed contained ruptured 57 × 63 mm AAA protruded into the L4 vertebra. The patient was scheduled for an open repair through a midline laparotomy. Microbiological examination from the AAA sack revealed positive culture of Staphylococcus hominis. After the procedure a three-week antibiotic treatment with Linezolid was started in the patient.

Results: Currently we have three-month follow up of the patient with no signs of infection in the aortic polyester graft based on ultrasonography.

Conclusion: Low back pain is a widespread medical diagnosis. However, its reason may not always be a primary spine disease. Chronic contained ruptured AAA with vertebral body erosion is an uncommon manifes- tation of a ruptured AAA.

Keywords: Abdominal aneurysm, Contained rupture, Erosion, Infection, Vertebrae

Received: July 29, 2019; Revised: August 20, 2019; Accepted: December 5, 2019; Published: July 29, 2020  Show citation