Traumatic abdominal aortic false aneurysm

Case contributed by Dr Andrew Lawson

Presentation

Blunt abdominal trauma

Retroperitoneal haematoma in the upper abdomen surrounds the abdominal aorta also involves left perirenal space with thickening of pararenal fascia. 

A large volume pneumoperitoneum is also present.

A 3.5 mm outpouching from the left lateral wall of the upper abdominal aorta just inferior to the level of the coeliac axis ( L1 level ) is located short distance anterior to a tiny arterial branch. This is the epicentre of the upper abdominal haematoma and may represent small false aneurysm either from traumatic transection or at the site of avulsion of a small aortic branch. No intimal dissection flap is identified.

Case Discussion

The false aneurysm could not be identified on the 5mm thick slices. Close review of the thins revealed the point of bleeding.

Repeat CTA 1 week later demonstrated spontaneous thrombosis of the tiny false aneurysm.

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Case information

rID: 25627
Case created: 1st Nov 2013
Last edited: 11th Oct 2017
Tag: trauma
Inclusion in quiz mode: Included

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