Case Report
Massive
Infra-renal Abdominal Aortic Aneurysm: Case Report and Literature Review
Mohamed A. M. Altayeb*1, Abd Elaziz A. Suliman¹,
Einas R. E. Hamed1, Gazali Elhasan1,2,
Mohammed A. A. Abdelmotalab3,4,
Abdelmoiz E. A. Mohamed5, Rayan J. O. Hamid6,
Abdulwahab
H. A. Abdulkarim7, Dahlia A. A. Mohammad6
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Abstract:
An aneurysm is a localized dilatation in a
blood vessel wall, typically in an artery, resulting from a defect, illness, or
injury. It can be life-threatening, especially when it involves the abdominal
aorta. Risk factors include atherosclerosis, smoking, hypertension, advanced
age, family history, and male gender. Its prevalence ranges from 12.5% in males
to 5.2% in females. A 65-year-old male with no known risk factor for
cardiovascular disease presented with lower back pain for five years and
erectile dysfunction for more than 20 years. On examination, a pulsating
epigastric mass was found. A regular abdominal ultrasound examination revealed
an epigastric mass. Routine investigations and echocardiography were
unremarkable. Computed Tomography abdominal angiography revealed a large
infra-renal abdominal aortic aneurysm (AAA), patent centrally with a peripheral
mural thrombus opposite the second, third, and fourth lumbar vertebrae. There
were no features indicating a rupture. An elective AAA repair was performed
through a standard midline trans-peritoneal approach. A Dacron graft measuring
18 mm was applied for the repair. Both the surgery and the post-operative
recovery were uneventful. At the time of the report, the patient has been alive
and well been periodically followed up for over 18 months since the operation.
Conclusion: Early
diagnosis of infrarenal AAAs is critical due to the significant death rate
associated with rupture. A high level of
suspicion is required for diagnosis of cases with unusual presentations such as
vague abdominal and back pain and early erectile dysfunction.
Keywords: case report,
abdominal aortic aneurysm, mural thrombus, Dacron graft
1 Department
of Surgery, Soba University Hospital, Khartoum, Sudan
2 Sudan
University for Science and Technology, Khartoum, Sudan
3 Department
of Anatomy, Faculty of Medicine and Health Science, Omdurman Islamic university,
Omdurman, Sudan.
4 Anatomy
Department, Faculty of Medicine, International University of Africa, Khartoum,
Sudan.
5 Emergency and
Trauma Department, Al-naw Teaching Hospital, Omdurman, Sudan.
6 Anatomy
Department, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
7 Anatomy
department, faculty of Medicine, National University, Khartoum, Sudan
* Corresponding
Author: Mohamed Alnaeem Mohamed Altayeb, Department of Surgery, Soba University
Hospital.
Email: mohamedalnaeem2016@gmail.com ORCID: https://orcid.org/0000-0002-2727-5309
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