title: Spinal destruction induced by chronic contained rupture of an abdominal aortic aneurysm: report of a case.
abstract: We report a case of spinal destruction caused by chronic contained rupture of an abdominal aortic aneurysm (AAA). The patient was a 73-year-old man who had undergone coronary artery bypass grafting, sigmoidectomy for colon cancer, and axillofemoral bypass with AAA resection within months of each other, 3 years earlier. Abdominal computed tomography and magnetic resonance imaging showed destruction of the 12th thoracic and 1st lumbar vertebrae. The possibility of a metastatic spine tumor prompted us to consult the orthopedic surgeons, who recommended a spinal percutaneous needle aspiration biopsy. However, the cardiovascular surgeons diagnosed chronic contained rupture of an inflammatory AAA. The patient gradually improved with antimicrobial treatment, but died of disseminated intravascular coagulation the following year. The definitive diagnosis was confirmed by autopsy. We report this case for its educational value, considering the serious consequences that might have occurred had we attempted to biopsy the lesion.
authors.affiliation: Fourth Department of Surgery, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ubukata
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Kasuga
authors.forename: Gyou
authors.initials: G
authors.lastname: Motohashi
authors.forename: Motonobu
authors.initials: M
authors.lastname: Katano
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tabuchi
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications*; D001019:Aortic Rupture / Q000150:complications*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D007249:Inflammation; D008297:Male; D013122:Spinal Diseases / Q000175:diagnosis / Q000209:etiology*