Late lumbar hemorrhage after open repair of abdominal aortic aneurysm: computed tomographic appearance resembling type II endoleak.
Development of endoleak after conventional open repair of abdominal aortic aneurysm is less well documented compared with endovascular stenting. We present a case report of a 65-year-old man who had sudden onset of back pain with central abdominal tenderness 34 days after successful open repair of an abdominal aortic aneurysm. Urgent laparotomy revealed the presence of a noninfective intrasac hemorrhage, due to recanalization of the lumbar arteries. These were successfully suture ligated. Delayed lumbar hemorrhage should be an important differential diagnosis by frontline medical personnel in patients with recent open aneurysm repair. The recent literature on other causes and management strategies is also reviewed.
Yow
Heng
H
Academic Department of Vascular Surgery, York District General Hospital, Yorkshire Y031 8HE, UK. bmbkhy@bmb.leeds.ac.uk
McCleary
Alistair J
AJ
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D006801:Humans; D007813:Laparotomy; D008026:Ligation / Q000379:methods; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology; D008159:Lumbar Vertebrae / Q000098:blood supply*; D018810:Magnetic Resonance Angiography; D008297:Male; D011475:Prosthesis Failure; D011859:Radiography; D018570:Risk Assessment; D016896:Treatment Outcome