Spontaneous perforation of a nonaneurysmal infrarenal aorta.
Spontaneous perforation of a nonaneurysmal abdominal aorta due to a penetrating atherosclerotic ulcer (PAU) is exceedingly rare. We describe the case of a 57-year-old man with a perforating PAU of the infrarenal aortic wall and discuss the clinical presentation, diagnostic pathways, and therapeutic options based on a comprehensive review of the literature. Since a PAU of the aorta can give rise to chronic mild to moderate abdominal or back pain, a computed tomographic scan of the abdomen should be performed in patients with evidence of vascular disease and persistent abdominal or back discomfort. Surgical resection or stent-graft placement is indicated in symptomatic patients or in asymptomatic patients with radiographic signs of progressive PAU.
Thalheimer
Andreas
A
Department of Vascular Surgery, University of Wuerzburg, Oberduerrbacher str. 6, 97080 Wuerzburg, Germany. Thalheimer_A@chirurgie.uni-wuerzburg.de
Larena-Avellaneda
Axel
A
Buhler
Christoph
C
Meyer
Detlef
D
Franke
Siegfried
S
D015746:Abdominal Pain / Q000209:etiology; D001018:Aortic Diseases / Q000175:diagnosis* / Q000601:surgery; D050197:Atherosclerosis / Q000150:complications* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D008875:Middle Aged; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed