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J Endovasc Ther. 2003 Apr;10(2):392-6.

Abdominal aortic intramural hematoma related to penetrating ulcer: an inappropriate indication for endovascular repair?

Author information

1
Department of Vascular Surgery, University of L'Aquila, Italy. marco.ventura4@tin.it

Abstract

PURPOSE:

To present a rare case of abdominal aortic intramural hematoma with penetrating ulcer.

CASE REPORT:

A 68-year-old hypertensive lady was admitted with chest pain. An echo Doppler abdominal study showed a 2.5-cm-diameter abdominal aorta with periaortic blood flow. Urgent computed tomography documented a 4-cm aneurysmal dilatation, 4 cm long, at the infrarenal level of the inferior mesenteric artery origin, which appeared on the angiogram as a very short lateral bleb. At elective open laparotomy, no true abdominal atherosclerotic aneurysm was found in the retroperitoneal space, but rather, an intramural hematoma with ulcer. An aortobi-iliac graft was inserted, and the patient was discharged with a good outcome. Histological examination of the explanted tissue confirmed adventitial calcifications, organized thrombus in the hematoma, and intimal neovascularization.

CONCLUSIONS:

Considering the pathology, this case was more appropriately treated with open surgery, although endovascular repair was not excluded as an option.

PMID:
12877630
DOI:
10.1177/152660280301000237
[Indexed for MEDLINE]

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