PMC6849896_01
A, Multiplanar computed tomography (CT) coronal reconstruction showed a left retroperitoneal rupture of a large aneurysm involving the infrarenal aorta and both common iliac arteries. Spread calcifications of arterial wall suggestive of atherosclerosis were seen. B, Transesophageal echocardiography showed a vegetative mass on the sigmoid cusp of the aortic valve (arrow). C,18F-Fluorodeoxyglucose positron emission tomography combined with CT showed an abnormal focal uptake (maximum standardized uptake value = 2.9) in the aortic valve plane (arrow). D, Microscopic analysis of abdominal and iliac aneurysm (left, original magnification x5) showed an intima-media inflammatory mononuclear infiltrate (top right, x200) well separated from a lipid-rich necrotic core and fibrosis (bottom right, x100).
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Computed tomography (CT) body scan revealed a left retroperitoneal rupture of a large aortoiliac aneurysm (Fig 1, A). Transesophageal echocardiography showed aortic valve vegetation with mild regurgitation (Fig 1, B). 18F-Fluorodeoxyglucose positron emission tomography combined with CT showed an increased uptake of the anterobasal region of the heart ventricular septum (Fig 1, C). Pathologic analysis of abdominal and iliac aneurysm specimens showed inflammatory cellular infiltrate with giant cells in the media associated with a lipid-rich necrotic core and fibrosis (Fig 1, D).
Axial computed tomography (CT) scan showing the large retroperitoneal hematoma at admission (A) and its complete resorption 6 months after surgery (B). No evidence for infection of the prosthetic graft was seen (C).
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Control CT scan showed no evidence of infection of the prosthetic graft (Fig 2).