Reference : Chronic rupture of abdominal aortic aneurysm manifesting as crural neuropathy.
Scientific journals : Article
Human health sciences : Surgery
http://hdl.handle.net/2268/36045
Chronic rupture of abdominal aortic aneurysm manifesting as crural neuropathy.
English
Defraigne, Jean-Olivier mailto [Université de Liège - ULg > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique]
SAKALIHASAN, Natzi mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire]
LAVIGNE, Jean-Paul [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire]
VAN DAMME, Hendrik mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie cardio-vasculaire]
Limet, Raymond [Université de Liège - ULg > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique]
2001
Annals of Vascular Surgery
Springer Verlag
15
3
405-11
Yes
International
0890-5096
1615-5947
New York
NY
[en] Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/complications/diagnosis ; Aortic Rupture/complications/diagnosis ; Chronic Disease ; Humans ; Leg/innervation ; Male ; Middle Aged ; Peripheral Nervous System Diseases/etiology
[en] Chronic rupture of abdominal aortic aneurysm (AAA) resulting in unusual clinical manifestations can occur if the resistance of structures surrounding the aorta is sufficient to contain hemorrhage. In this report, we describe five cases of chronic ruptured AAA in which the presenting feature was crural neuropathy. All patients were male with a mean age of 74 +/- 1.8 years. At the time of presentation, crural neuropathy had been ongoing for 3 to 9 weeks. In three cases, AAA was not initially suspected because an inadequate clinical examination was performed (not in the vascular surgery department) and because of the small diameter of the aorta in relation to the patient's morphology. Two patients had one episode of hypotension that was wrongly attributed to vagal attack. Abdominal CT scanning was always diagnostic of chronic rupture. In two cases, rupture was associated with erosion of the body of one or more vertebrae and laboratory evidence of inflammation, i.e., increase in sedimentation rate and fibrinogen level. The mean diameter of the AAA was 7.1 +/- 0.9 cm (range 5-10 cm). All patients underwent midline laparotomy, which was performed under emergency conditions in two cases, under semi-emergency conditions in one case, and electively in two cases. Perforation was consistently located on the posterolateral wall of the aorta and varied from 1 to 3 cm in length. Repair was performed using an aortobifemoral prosthesis in four cases, and a straight tube in one case. The patient who underwent emergency surgery died 4 days after the procedure. The remaining four patients recovered uneventfully and were discharged after 10 days. In the elderly, ruptured AAA should be included in the differential diagnosis of crural neuropathy. An episode of hypotension, regardless of its duration, in an elderly patient should be given serious consideration as a possible sign of ruptured AAA with ongoing retroperitoneal hemorrhage.
http://hdl.handle.net/2268/36045
also: http://hdl.handle.net/2268/143448
10.1007/s100160010069

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