Diagnosis and perioperative management of ruptured AAA mimicking symptomatic groin hernia

Holger Jan Klein; Daniel Becker; Zoran Rancic

doi:10.1016/j.ijscr.2015.11.020

Diagnosis and perioperative management of ruptured AAA mimicking symptomatic groin hernia

Int J Surg Case Rep. 2016:18:1-4. doi: 10.1016/j.ijscr.2015.11.020. Epub 2015 Nov 27.

Authors

Holger Jan Klein¹, Daniel Becker², Zoran Rancic³

Affiliations

¹ Division of Cardiovascular Surgery, University Hospital Zurich, Switzerland. Electronic address: klein.holger@googlemail.com.
² Division of Cardiovascular Surgery, University Hospital Zurich, Switzerland. Electronic address: daniel.becker@usz.ch.
³ Division of Cardiovascular Surgery, University Hospital Zurich, Switzerland. Electronic address: zoran.rancic@usz.ch.

Abstract

Introduction: Ruptured abdominal aortic aneurysm (RAAA) can infrequently present as symptomatic groin hernia. This misleading form of presentation often leads to erroneous preoperative management resulting in poor survival.

Case presentation: Two patients with RAAA mimicking symptomatic groin hernia underwent different preoperative managements pointing out the importance of the principles of hypotensive haemostasis in the scope of this emergency scenario.

Conclusion: Computed Tomography Angiography (CTA) remains the recommended diagnostic tool-for both safe diagnosis of the ruptured aneurysm and precise preoperative planning. Endovascular aortic repair of the RAAA-if feasible-is the treatment of choice. This rare form of RAAA manifestation should call physicians attention-especially in patients with known abdominal aortic aneurysms in their preceding medical history.

Keywords: EVAR; Inguinal hernia; Ruptured abdominal aortic aneurysm.