Skip to main content

Advertisement

SpringerLink
Log in

Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Purpose

To assess the CT features of sealed rupture of abdominal aortic aneurysm.

Patients and methods

We reviewed the CT scans of six index cases obtained over a 3 year period with a sealed rupture of an abdominal aortic aneurysm and those reported in the literature over a 21 year period. CT scans were reviewed for aneurysm size, the presence of a draped aorta and adjacent vertebral erosion. A group of consecutive patients with non-ruptured abdominal aortic aneurysm, referred for endovascular aneurysm repair during the same 3 year period constituted the control group.

Results

In the study group of 31 patients the mean size of the aneurysm was 6.24 ± 2.01 cm, compared to 6.01 ± 0.99 cm in the control group, without statistically significant difference (t = 0.75, df = 97, P = 0.46). A draped aorta was detected in all patients with a sealed rupture. Vertebral erosion was present in all our six, but mentioned in only 14 of the cases reported.

Conclusion

A sealed rupture of an abdominal aortic aneurysm can occur in relatively small aneurysms. A draped aorta and adjacent vertebral erosion are characteristic CT signs of such a rupture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Siegel CL, Cohan RH (1994) CT of abdominal aortic aneurysms. AJR 163:17–29

    CAS  PubMed  Google Scholar 

  2. Bhalla S, Menias CO, Heiken JP (2003) CT of acute abdominal aortic disorders. RCNA 41:1153–1169

    Article  Google Scholar 

  3. Schwartz SA, Taljanovic MS, Smyth S, O`Brien MJ, Rogers LF (2007) CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms. AJR 188:W57–W62

    Article  PubMed  Google Scholar 

  4. Rakita D, Newatia A, Hines JJ, Siegel DN, Friedman B (2007) Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. RadioGraphics 27:497–507

    Article  PubMed  Google Scholar 

  5. Choplin RH, Karstaedt N, Wolfman NT (1982) Ruptured abdominal aortic aneurysm simulating pyogenic vertebral spondylitis. AJR 138:748–750

    CAS  PubMed  Google Scholar 

  6. Grevitt MP, Fagg PS, Mulholland RC (1996) Chronic contained rupture of an aortic aneurysm mimicking infective spondylitis. Eur Spine J 5:128–130

    Article  CAS  PubMed  Google Scholar 

  7. Sakai T, Katoh S, Sairyo K, et al. (2007) Extension of contained rupture of an abdominal aortic aneurysm into a lumbar intervertebral disc. J Neurosurg Spine 7:221–226

    Article  PubMed  Google Scholar 

  8. Kapoor V, Kanal E, Fukui MB (2001) Vertebral mass resulting from a chronic-contained rupture of an abdominal aortic aneurysm repair graft. AJNR 22:1775–1777

    CAS  PubMed  Google Scholar 

  9. Gandini R, Chiocchi M, Maresca L, et al. (2008) Chronic contained rupture of an abdominal aortic aneurysm: from diagnosis to endovascular resolution. Cardiovasc Intervent Radiol 31(Suppl 2):S62–S66

    Article  PubMed  Google Scholar 

  10. Nonami Y, Okazaki Y, Yamashiro T, Ogoshi S (1995) Chronic contained rupture of an abdominal aortic aneurysm. Cardiovasc Surg 3:227–229

    Article  CAS  PubMed  Google Scholar 

  11. Ubukata H, Kasuga T, Motohashi G, Katano M, Tabuchi T (2005) Spinal destruction induced by chronic contained rupture of an abdominal aortic aneurysm: report of a case. Surg Today 35:411–414

    Article  PubMed  Google Scholar 

  12. Horowitz M, Gayer G, Itzchak Y, Rapoport MJ (2006) To biopsy or not to biopsy: an 82-year-old patient with a retroperitoneal mass and severe low back pain. Eur J Intern Med 17:55–56

    Article  PubMed  Google Scholar 

  13. Jones CS, Reilly MK, Dalsing MC, Glover JL (1986) Chronic contained rupture of abdominal aortic aneurysms. Arch Surg 121:542–546

    CAS  PubMed  Google Scholar 

  14. Sterpetti AV, Blair EA, Schultz RD, et al. (1990) Sealed rupture of abdominal aortic aneurysms. J Vasc Surg 11:430–435

    Article  CAS  PubMed  Google Scholar 

  15. Bonamigo TP, Becker M, Weber ELSW, et al. (2006) Outcome after surgical repair of sealed rupture abdominal aortic aneurysms: a case-control study. Clinics 61(1):29–34

    Article  PubMed  Google Scholar 

  16. Halliday CE, Al-Kutoubi A (1996) Draped aorta: CT sign of contained leak of aortic aneurysms. Radiology 199:41–43

    CAS  PubMed  Google Scholar 

  17. Higgins R, Peitzman AB, Reidy M, et al. (1988) Chronic contained rupture of an abdominal aortic aneurysm presenting as a lower extremity neuropathy. Ann Emerg Med 17:284–287

    Article  CAS  PubMed  Google Scholar 

  18. Rosenthal D, Clark ND, Stanton PE Jr, Lamis PA (1986) “Chronic-contained” ruptured abdominal aortic aneurysm: is it real? J Cardiovasc Surg (Torino) 27:723–724

    CAS  Google Scholar 

  19. Nakagawa Y, Masuda M, Shiihara H, et al. (1990) A chronic contained rupture of an abdominal aortic aneurysm complicated with severe back pain. Ann Vasc Surg 4:189–192

    Article  CAS  PubMed  Google Scholar 

  20. Galessiere PF, Downs AR, Greenberg HM (1994) Chronic, contained rupture of aortic aneurysm associated with vertebral erosion. Can J Surg 37:23–28

    CAS  PubMed  Google Scholar 

  21. Aune S, Trippestad A (1995) Chronic contained rupture of an abdominal aortic aneurysm complicated by infection and femoral neuropathy. Eur J Surg 161:613–614

    CAS  PubMed  Google Scholar 

  22. Ohtake H, Mukai K, Watanabe Y (1996) Twice sealed-rupture of a small abdominal aortic aneurysm with unusual computed tomography findings. A case report. J Cardiovasc Surg (Torino) 37(3):249–250

    CAS  Google Scholar 

  23. Villegas-Cabello O, Silier J (1999) Asymptomatic rupture of an aortoiliac aneurysm. Tex Heart Inst J 26:219–222

    CAS  PubMed  Google Scholar 

  24. Edrees WK, Lee B (2000) A rare case of radiculopathy in an elderly man. Postgrad Med J 76:586, 591–592

    Google Scholar 

  25. Dorrucci V, Dusi R, Cordiano C (2001) Contained rupture of an abdominal aortic aneurysm presenting as obstructive jaundice: report of a case. Surg Today 31:331–332

    Article  CAS  PubMed  Google Scholar 

  26. Defraigne JO, Sakalihasan N, Lavigne JP, Van Damme H, Limet R (2001) Chronic rupture of abdominal aortic aneurysm manifesting as crural neuropathy. Ann Vasc Surg 15:405–411

    Article  CAS  PubMed  Google Scholar 

  27. Szpinda M, Flisin`ski P, Molski S (2001) ‘Chronic-contained’ rupture abdominal aortic and right common iliac artery aneurysms. Case Rep Clin Pract Rev 2:112–115

    Google Scholar 

  28. Ando M, Gary T, Yokoyama H, Satokawa H (2003) CT features of chronic contained rupture of an abdominal aortic aneurysm. Ann Thorac Cardiovasc Surg 9:274–278

    PubMed  Google Scholar 

  29. Saiki M, Urata Y, Katoh I, Hamasaki T (2006) Chronic contained rupture of an abdominal aortic aneurysm with vertebral erosion: report of a case. Ann Thorac Cardiovasc Surg 12:300–302

    PubMed  Google Scholar 

  30. Bansal M, Bansal M, Thukral BB, Malik A (2006) Contained rupture of thoracoabdominal aortic aneurysm presenting as a back mass. J Thorac Imaging 21:219–221

    Article  PubMed  Google Scholar 

  31. Obinata D, Takenobu Y, Sakuma T, et al. (2007) Chronic contained rupture of an abdominal aortic aneurysm mimicking a retroperitoneal tumor. Hinyokika Kiyo 53:397–399

    PubMed  Google Scholar 

  32. Szilagyi DE, Smith RF, Macksood AJ, Whitcomb JG (1961) Expanding and ruptured abdominal aortic aneurysms. Problems of diagnosis and treatment. Arch Surg 83:395–408

    CAS  PubMed  Google Scholar 

  33. Al-Koteesh J, Masannat Y, James NVM, Sharaf U (2005) Chronic contained rupture of abdominal aortic aneurysm presenting with longstanding back pain. SMJ 50:122–123

    CAS  Google Scholar 

  34. Ramasamy PR, Fox D, Narendra G, Carnie L, Watura R (2001) Chronic contained leak of abdominal aortic aneurysm presenting as lumbar neuropathy. J R Coll Surg Edinb 46:307–309

    CAS  PubMed  Google Scholar 

  35. Maclaurin WAM, Hawkins SP (1997) The “draped aorta” in leaking aneurysms: aneurysm size correlation should have been provided. Radiology 203:578

    CAS  PubMed  Google Scholar 

  36. Darling RC (1970) Ruptured arteriosclerotic abdominal aortic aneurysms: a pathologic and clinical study. Am J Surg 119:397–401

    Article  CAS  PubMed  Google Scholar 

  37. Siegel CL, Cohan RH, Korobkin M, et al. (1994) Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. AJR 163:1123–1129

    CAS  PubMed  Google Scholar 

  38. Macedo TA, Stanson AW, Oderich GS, et al. (2004) Infected aortic aneurysms: imaging findings. Radiology 231:250–257

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging, Sheba Medical Center (Affiliated to Sackler School of Medicine, Tel-Aviv University), Tel-Hashomer, Israel

    S. Apter, U. Rimon, E. Konen, L. Guranda, M. Amitai, O. Portnoy & M. Hertz

  2. The Open University of Israel, Raànana, Israel

    Z. Erlich

  3. Department of Diagnostic Imaging, Assaf-Harofeh Medical Center (Affliated to Sackler School of Medicine, Tel-Aviv University), Zerifin, Israel

    G. Gayer

Authors
  1. S. Apter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Rimon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Konen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Z. Erlich
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Guranda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Amitai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. O. Portnoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G. Gayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M. Hertz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Apter.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Apter, S., Rimon, U., Konen, E. et al. Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature. Abdom Imaging 35, 99–105 (2010). https://doi.org/10.1007/s00261-008-9488-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-008-9488-1

Keywords

Search

Navigation