RESUMO
Abdominal aortic aneurysm (AAA) is a common medical condition with the feared, and often fatal, complication of rupture. The risk of rupture has been well documented to correlate with aneurysm size. It is exceedingly rare for an AAA less than 5 cm to rupture. This case report demonstrates an asymptomatic 4.3 cm AAA that ruptured while admitted to the hospital with COVID-19 pneumonia. The patient was successfully managed with an endovascular aortoiliac stent graft. Although rare, in patients with small AAA, rupture must remain in the differential diagnosis in the setting of acute onset abdominal or back pain. Furthermore, when quickly recognized, these patients can be safely managed with an endovascular approach.
Assuntos
Aneurisma da Aorta Abdominal , Ruptura Aórtica , Implante de Prótese Vascular , Procedimentos Endovasculares , Humanos , Ruptura Aórtica/diagnóstico por imagem , Ruptura Aórtica/etiologia , Ruptura Aórtica/cirurgia , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Stents/efeitos adversos , Aorta , Procedimentos Endovasculares/efeitos adversos , Implante de Prótese Vascular/efeitos adversos , Resultado do Tratamento , Fatores de RiscoRESUMO
Secondary aortoesophageal fistula (AEF) is a rare but catastrophic complication that occurs after thoracic aortic reconstruction. Recently endoluminal stent grafts have been used in selected patients with a thoracic aortic aneurysm, dissection, or traumatic aortic transection. A 24-year-old woman had massive upper gastrointestinal tract bleeding 15 months after endoluminal stent graft placement because of traumatic descending thoracic aortic transection. Evaluation demonstrated an AEF from the mid-esophagus to the endoluminal stent graft. The endoluminal graft was explanted, with primary repair of the thoracic aortic defect and simultaneous primary repair of the esophageal injury. The patient is well 15 months after open repair of the AEF.