[Abdominal pain as a symptom of a late complication following endovascular treatment of an aneurysm of the abdominal aorta].
A 72-year-old man presented with progressive pain in the left lower abdomen thought to be due to diverticulitis of the colon. Antimicrobial therapy had not reduced the symptoms. Four years before, during an endovascular procedure, the patient had been given a stent because of an abdominal aortic aneurysm (AAA). A CT scan showed a large retroperitoneal haematoma on the left side and an increased diameter of the AAA of 8.5 cm. X-rays showed a gap between the endovascular stent and the left iliac leg of the endoprosthesis. Due to the space between the two grafts, there was retroperitoneal leakage ofblood. In endovascular surgery this life-threatening situation is called a type III endoleak. The patient was operated immediately using the endovascular technique. Through the left femoral artery a new coated stent was positioned over the gap, which led to rapid recovery of the patient. Patients with abdominal pain and a history of a vascular endoprosthesis should be given a CT scan and plain radiography to exclude an endoleak.
Landman
M L
ML
Amphia Ziekenhuis, locatie Molengracht, Breda. mattijslandman@hotmail.com
van der Laan
L
L
de Groot
H G W
HG
van der Waal
J
J
Vos
L D
LD
Geenen
G P J
GP
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods*; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D012187:Retroperitoneal Space; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome