Chronic contained rupture of abdominal aortic aneurysm with extensive erosion of the vertebral bodies
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Remarkable aneurysmal dilatation of abdominal aorta at the origin of renal arteries, which extends to the bifurcation of aorta associated with extensive mural thrombosis. Extensive erosion of anterior part of L3 and L4 vertebrae and loss of outline of the right psoas muscle. Contrast material completely fills the renal and common iliac arteries. There is no evidence of leakage of contrast material in the surrounding haematoma.
The draped aorta sign was considered in this case because a distinct line between the posterior aorta and adjacent structures was not identifiable, additionally to the fact that the posterior aorta followed the vertebral contour. This sign is considered to be specific to a chronically ruptured aneurysm. Another specific imaging finding observed in this case were smooth and well-corticated vertebral erosions with sclerotic borders, usually caused by aneurysms secondary to chronic repetitive arterial pulsations.