Right retroperitoneal haematoma from ruptured abdominal aortic aneurysm repair

Case contributed by RMH Core Conditions

Presentation

Post AAA repair.

Patient Data

Age: 66
Gender: Male

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-centred retroperitoneal haematoma measures approximately 13.5cm (ap) x 7.7cm (trans) x 21cm (cc).

Small bilateral haematomas 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 haematoma, fluid or infection within the psoas muscle. 

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Case Information

rID: 31136
Case created: 21st Sep 2014
Last edited: 10th Sep 2015
Inclusion in quiz mode: Included

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