Delayed-onset ruptured abdominal aortic aneurysm post-endovascular repair
Presentation
Severe lower abdominal pain, repeated vomiting, generalized abdominal tenderness, and left lower-sided hard swelling. Suspected obstructed inguinal hernia.
Patient Data
Large retroperitoneal hematoma of mixed density surrounding the aortoiliac stent graft. It extends to involve the left perirenal space. Thickening of Gerota's fascia and marked stranding in the perinephric fat on the left side. A small volume of intraperitoneal free fluid.
Both femoral arteries are patent.
Case Discussion
This is a case of a delayed abdominal aortic aneurysm rupture 5 years after endovascular repair with a bifurcated stent graft. Despite recent improvements in endovascular repair techniques, delayed complications, including aneurysmal sac enlargement, stent migration, and endoleak, can happen due to failure to completely exclude the aneurysm. Continuous surveillance is essential and has a huge impact on complication-related patient mortality.
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