Abdominal pain and hemoperitoneum: sole presenting symptoms for "leaking AAA" after endovascular repair.
OBJECTIVE
To describe an unusual presentation of impending aortic endograft rupture and successful endovascular rescue.


METHODS
A 77-year-old man with an enlarging aortic aneurysm was treated with a Talent bifurcated endoprosthesis; a moderate endoleak that appeared to be related to either proximal or distal fixation sites was noted in the body of the aneurysm. The patient was observed for 1 month, and repeat imaging demonstrated persistent endoleak without major increase in the aneurysm diameter. Another examination was scheduled for 3 months hence, but, 2 months later, the patient presented with abdominal pain and a hemoperitoneum. A proximal extension cuff resolved the leak and led to resolution of the hemoperitoneum.


CONCLUSIONS
A leaking aneurysm can be repaired using endovascular techniques in patients with an existing endograft. The need for frequent imaging surveillance of patients with endoleak is underscored.
White
R A
RA
Division of Surgery, Harbor-UCLA Medical Center, Torrance, California 90509-9823, USA. raw@ucla.edu
Donayre
C E
CE
Walot
I
I
Kopchok
G
G
Woody
J
J
D015746:Abdominal Pain / Q000209:etiology*; D000368:Aged; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D006465:Hemoperitoneum / Q000209:etiology*; D006801:Humans; D008297:Male; D014656:Vascular Surgical Procedures