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Ziani C, Missaoui Z, Oukrid K, Haddar L, Kasimi A, Nasri S, Kamaoui I, Skiker I. Case report - Computed tomography diagnosis of an abdominal aortic aneurysm complicated with primary aortoduodenal fistula. Radiol Case Rep 2024; 19:1980-1985. [PMID: 38434788 PMCID: PMC10909590 DOI: 10.1016/j.radcr.2024.01.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 03/05/2024] Open
Abstract
Abdominal aortic aneurysm has been described as a rare condition touching 1% of the population over the age of 50 years with a high percentage of mortality. Aneurysms progress in size, causing deadly complications such as ruptures and fistulas. Computed tomography angiography is considered the gold standard imaging exam for the evaluation of abdominal aortic aneurysms and their complications. We report the case of an elderly patient admitted to the emergency room due to recurrent gastrointestinal bleeding. The computed tomography imaging findings were in favor of an abdominal aortic aneurysm complicated with a primary aortoduodenal fistula.
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Affiliation(s)
- Chaymae Ziani
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
| | - Zakariae Missaoui
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
| | - Khaoula Oukrid
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
| | - Leila Haddar
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
| | - Asmae Kasimi
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
| | - Siham Nasri
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
| | - Imane Kamaoui
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
| | - Imane Skiker
- Department of Radiology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine, University Mohammed First, BP 4806 Oujda University, Oujda, Morocco
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Patel TV, Canario DAH, Isaacson AJ, Mauro DM. Vascular Etiologies of the Acute Abdomen. Semin Roentgenol 2020; 55:417-426. [PMID: 33220787 DOI: 10.1053/j.ro.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Tirth V Patel
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC
| | | | - Ari J Isaacson
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - David M Mauro
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC.
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Kichloo A, Khan MZ, Zain EA, Vipparla NS, Wani F. Post-Endovascular Abdominal Aortic Aneurysm Repair Abdominal Pain: A Learning Experience. J Investig Med High Impact Case Rep 2019; 7:2324709619865575. [PMID: 31347409 PMCID: PMC6661783 DOI: 10.1177/2324709619865575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is one of the important pathologies involving the
abdominal aorta, as it can have adverse consequences if it goes unnoticed or
untreated. AAA is defined as an abnormal dilation of the abdominal aorta 3 cm or
greater. Endovascular abdominal aortic aneurysm repair (EVAR) has recently
emerged as a treatment modality for AAA. It does have a few inherent
complications that include endoleak, endograft migration, bleeding, ischemia,
and compartment syndrome. This case report discusses a patient who came in with
abdominal pain and a pulsatile mass, which raised concerns regarding endoleak.
The patient had a 9.9-cm AAA, which was repaired in the past, as was made
evident by computed tomography findings of the stent graft in the aneurysmal
segment. This case stands out because it highlights the importance of comparing
the size of the AAA at the time of the EVAR to the current scenario where the
patient presents with abdominal pain of unknown etiology. Also, this case report
highlights the importance of computed tomography and other imaging forms in
following-up with patients who have EVAR for AAAs.
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Affiliation(s)
- Asim Kichloo
- 1 St. Mary's Hospital, Saginaw, MI, USA.,2 Central Michigan University, Saginaw, MI, USA
| | - M Zatmar Khan
- 1 St. Mary's Hospital, Saginaw, MI, USA.,2 Central Michigan University, Saginaw, MI, USA
| | - El-Amir Zain
- 1 St. Mary's Hospital, Saginaw, MI, USA.,2 Central Michigan University, Saginaw, MI, USA
| | - Navya Sree Vipparla
- 1 St. Mary's Hospital, Saginaw, MI, USA.,2 Central Michigan University, Saginaw, MI, USA
| | - Farah Wani
- 1 St. Mary's Hospital, Saginaw, MI, USA.,2 Central Michigan University, Saginaw, MI, USA
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Evaluation of the thrombus of abdominal aortic aneurysms using contrast enhanced ultrasound - preliminary results. Sci Rep 2016; 6:34152. [PMID: 27677245 PMCID: PMC5039714 DOI: 10.1038/srep34152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 09/08/2016] [Indexed: 12/30/2022] Open
Abstract
It is hypothesized that the degree of vascularization of the thrombus may have a significant impact on the rupture of aortic aneurysms. The presence of neovascularization of the vessel wall and mural thrombus has been confirmed only in histopathological studies. However, no non-invasive imaging technique of qualitative assessment of thrombus and neovascularization has been implemented so far. Contrast-enhanced ultrasound (CEUS) has been proposed as a feasible and minimally invasive technique for in vivo visualization of neovascularization in the evaluation of tumors and atherosclerotic plaques. The aim of this study was the evaluation of mural thrombus and AAAs wall with CEUS. CEUS was performed in a group of seventeen patients with AAAs. The mural thrombus enhancement was recognized in 12 cases, yet no significant correlation between the degree of contrast enhancement and AAAs diameter, thrombus width, and thrombus echogenicity was found. We observed a rise in AAAs thrombus heterogeneity with the increase in the aneurysm diameter (r = 0.62, p = 0.017). In conclusion CEUS can visualize small channels within AAAs thrombus, which could be a result of an ongoing angiogenesis. There is a need for further research to find out whether the degree of vascularization of the thrombus may have a significant impact on the rupture of aneurysms.
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