Right retroperitoneal hematoma from ruptured abdominal aortic aneurysm repair
Presentation
Post AAA repair.
Patient Data
The right psoas shadow is indistinct. Bowel gas pattern within normal limits. No evidence of established bowel obstruction.
Evidence of ruptured abdominal aortic aneurysm repair, a bifurcated synthetic graft wrapped within the native aneurysmal sac. A bulge in the left inferior aspect of the native aneurysmal sac likely represents the residual sac of a left common iliac artery aneurysm, excluded by the left-sided limb of the bifurcated graft. Very large, heterogeneous density, right-centered retroperitoneal hematoma measures approximately 13.5cm (ap) x 7.7cm (trans) x 21cm (cc).
Small bilateral hematomas at the sites of femoral artery cut-downs for graft anastomosis.
Case Discussion
Psoas muscle shadows are part of the "check areas" on abdominal x-rays. Its absence is a non-specific sign of hematoma, fluid or infection within the psoas muscle.
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