Spontaneous Rupture of a Nonaneurysmal Infrarenal Abdominal Aorta Due to Penetrating Ulcer

Abstract

Spontaneous rupture of nonaneurysmal, noninfected atherosclerotic infrarenal aorta is rare. In most cases it is due to penetrating atherosclerotic ulceration (PAU) of the aorta. However, this disease predominantly affects thoracic aorta. PAU of the infrarenal aorta is a rare entity. A case of spontaneous rupture through an atheromatous plaque with spontaneous rupture of infrarenal abdominal aorta is reported. In our case the patient presented with gastro-intestinal complaints, probably due to adhesion of the duodenum to the anterior aortic wall. This could not be corrected by an endovascular procedure. Therefore, we elected to perform an open repair. The patient recovered uneventfully and was discharged from the hospital on 9-th postoperative day. At early follow up the GI symptoms faded away and the patient tolerated food well and gain weight. Unfortunately the patient passed away at the 28-th postoperative day from a stroke.