Pseudoaneurysms of the abdominal aorta: MDCT findings.

Congress:

ECR 2020

Poster Number:

C-12570

Type:

Scientific Exhibit

Keywords:

Vascular, Arteries / Aorta, CT, Diagnostic procedure, Aneurysms, Infection, Trauma, Retrospective, Diagnostic or prognostic study, Performed at one institution

Authors:

E. E. BIgnardi¹, F. Baccaro², D. De Santo³, R. Filippelli⁴, C. Palumbo⁴, M. Coppola⁵; ¹Naples, Italy/IT, ²Caserta/IT, ³Napoli (NA), Italy/IT, ⁴Naples/IT, ⁵Cava de' Tirreni/IT

DOI:

10.26044/ecr2020/C-12570

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-12570

Fig. 1: Infected abdominal aorta pseudoaneurysm

Fig. 2: Infected abdominal aorta pseudoaneurysm. Signs of spondylodiscitis with...

Fig. 3: Rupture of AAP in patient affected by Staphylococcus aureus spondylodiscitis.

Fig. 4: Infrarenal multilobulated and saccular AAP in a patient affected by...

Purpose

The purpose of this retrospective study was to determine the MDCT angiographic findings characterizing psuedoaneurysms of the abdominal aorta (AAPs) AAPs are rare, accounting for about 1% of all aortic aneurysms, most often resulting from trauma, either penetrating or blunt trauma, interventional diagnostic and therapeutic procedures (like those involving arterial punctures or cardiac catheterization), atherosclerosis, chronic inflammation and infection. All these factors cause disruption of the arterial wall continuity, letting blood dissect into the tissues surrounding the damaged vessel, forming a sac in direct communication...

Methods and materials

In our study, we retrospectively reviewed 16 patients with AAP who underwent MDCT scan angiogram in the period between 2008 and 2018, using a 64-slice MDCT scan, integrated by high resolution reformatted images in bi- and three-dimensional planes (MPR, MIP, VR).

Results

Among 16 AAPs: 4 were the result of blunt traumas (car accidents or fall), 3 were complications of penetrating traumas (stab wounds), 2 were due to surgical procedures, 2 were due to interventional procedures, 2 were caused by infection, one case by vasculitis and one from neoplastic injury. Regardless of the underlying causing factor, all pseudoaneurysms show a thin-walled, irregular-shaped and contrast-filled sac in direct communication with the aorta. An infected AAP was suspected on the basis of CT finding of air bubbles in the...

Conclusion

Misdiagnosing aortic abdominal pseudoaneurysms (tumors or abscesses) can have severe consequences. Early diagnosis and surgical repair are essential in alleviating distressing symptoms and preventing other potentially serious complications, the main and most worrisome being rupture, which may rapidly lead the patient to death. In the past, the diagnosis of pseudoaneurysms of the abdominal aorta could be carried out exclusively by performing angiogram or after death by autopsy. Color Doppler US can be helpful, but currently MDCT angiogram is the diagnostic procedure of choice. It is...

Personal information and conflict of interest

E. Bignardi; - nothing to disclose F. Baccaro; - nothing to disclose D. De Santo; - nothing to disclose R. Filippelli; - nothing to disclose C. Palumbo; - nothing to disclose M. Coppola; - nothing to disclose Department of Radiology, Cotugno Hospital - Naples, ITALY

References

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