The patient presented with increasing left lower abdominal pain and associated with fevers. He had been transferred from a peripheral site for CT scanning.
The diagnosis was made of type II endoleak with suspicious for mycotic aneurysmal rupture.
The patient had previous CT from 2 years prior suspicious for endoleak but was unfortunately lost to follow up.
He was admitted under vascular for ongoing care. On angiogram a patent Riolan artery leading the IMA to feed the sac. This was coiled with good result. Subsequently, a small branch of the internal iliac artery feeding small collaterals which then led into a left lumbar vessel going towards the aneurysm sac was also detected. This was also coiled.