PMC7708768_01
The CT findings at outpatient.. (a) On contrast enhanced CT, a true aneurysm was identified near the right side of the terminal aorta.. (b) The aneurysm and duodenum were in contact. Air sign was identified within the wall of the aneurysm.. (c) Contrast enhanced CT revealed collateral vessels that had developed throughout the body.. (d)(e) Contrast enhanced CT revealed the occlusion of the aortic bifurcation. An aneurysm was found near the terminal aorta. The feeding artery of the aneurysm was suspected as right common iliac artery.
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Contrast-enhanced computed tomography (CT) revealed the occlusion of the terminal aorta and collateral vessels that had developed throughout the body (Fig. 1).
The findings of angiography.. (a) Angiography from right common iliac artery showed an aneurysm and its inflow and outflow vessels. The etiological artery was considered lumbar artery that developed as collateral pathway from the aorta to the right common iliac artery.. (b) Angiography revealed fistula and duodenum (arrow).
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Angiography from the right common iliac artery revealed blood flow to be reversed and directed toward the aneurysm (Fig. 2).
The intraoperative findings.. (a) The duodenal fistula was closed using linear stapler (arrow).. Debridement of the wall of the aneurysm wall was performed (circle).. (b) The coil used for embolization was exposed (circle).
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Dissection around the aneurysm was easily achieved, enabling the fistula between the aneurysm and the duodenum to be identified and closed using a linear stapler (Fig. 3a). Debridement of the wall of the aneurysm was performed until the coil was exposed (Fig. 3b), and then lavage was performed with a large amount of saline.