Reyna-Sepúlveda F, Rodríguez-García J, Chávez-Jiménez P, Rendón-Elías F, Hernández-Guedea M, Muñoz-Maldonado G

Language: Spanish
References: 6
Page: 112-115
PDF size: 150.38 Kb.

ABSTRACT

Background. The rupture of the abdominal aorta is caused by aneurysm, trauma or neoplasm. Spontaneous perforation of the abdominal aorta (SPAA) is extremely rare and the etiology is presumed to be an atheroesclerotic penetrating ulcer (APU).
Case report. We present a 56-year-old male patient who arrived to the emergency room referring intense lumbar pain, presents hemodynamically stable with pulsatile abdominal mass. A contrast abdominal computer tomography was done reporting contrast media extravasation located 1 cm before the aortic bifurcation. Aortotomy was done as an aortoiliac graft was sutured with the inferior mesenteric artery. The patient was discharged on the 6th postoperative day.
Discussion. SPAA for APU not associated to aneurysm is rare with only 22 cases reported in literature. The pathology characterized by the formation of an ulcer in the aortic wall that penetrates the intimal layer. The APU has been reported with an incidence of 3.4% in the abdominal aorta in the cases of aortic dissection. The capacity to survive the rupture will depend in the resistance to dissection of the retroperitoneal space to achieve the hematoma tamponade.
Conclusions. We describe the rare case of a SPAA that is extremely rare resulting from a APU in a diabetic patient with no previous history of smoking or hypertension. Because of its high mortality once the ulcer has ruptured and its importance as an absolute surgical emergency this must be thought in the differential diagnosis.

REFERENCES

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