A rare case of leaking abdominal aneurysm presenting as isolated right testicular pain

ABSTRACT An abdominal aortic aneurysm (AAA) is not usually considered in the differential diagnosis of isolated right testicular pain. We describe a patient who did present with isolated acute right testicular pain as the sentinel feature of a leaking AAA. In the patient group with right testicular pain, consideration of a leaking AAA should be added to the differential diagnosis. An adverse outcome can be avoided by timely diagnosis and intervention.

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Nyitott hasi aortaaneurysma-műtétek patkóvese fennállása esetén

Orvosi Hetilap ◽

10.1556/650.2020.31863 ◽

2020 ◽

Vol 161 (46) ◽

pp. 1966-1971

Author(s):

Sándor Bálint ◽

Zsuzsanna Mihály ◽

Zoltán Oláh ◽

Péter Sótonyi

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Horseshoe Kidney ◽

Emergency Operation ◽

Limb Ischaemia ◽

Abdominal Aneurysm ◽

Vascular Surgeon ◽

Accessory Renal Artery ◽

First Case ◽

Abdominal Aortic

Összefoglaló. A patkóvese a vese leggyakrabban előforduló fejlődési rendellenességeinek egyike. Hasi aortaaneurysmával való együttes előfordulása kifejezetten ritka (a hasi aortaaneurysmás esetek 0,12%-a). Az első esetben egy 64 éves férfi akut alsó végtagi panaszokkal került felvételre. A CT-angiográfia patkóvesét és thrombotizált infrarenalis aortaaneurysmát igazolt. Az akut műtét során a hasi aortaaneurysma resectióját és aortobifemoralis bypassműtétet végeztünk a patkóvese ishmusának megtartásával. A második esetben hasi panaszokat okozó, mindkét arteria iliaca communisra ráterjedő infrarenalis aortaaneurysma esetén végeztünk aortobiiliacalis rekonstrukciót. Az aneurysma előtt elhelyezkedő isthmus tervezetten szétválasztásra került, a poláris veseartériát visszaültettük. A tünetes hasi aortaaneurysma abszolút műtéti indikációt képez. A preoperatív CT- vagy MR-angiográfia kulcsfontosságú mind a műtéti indikáció felállítása, mind pedig a műtét megtervezése szempontjából. A beavatkozás előtt pontos képet kell kapnia az érsebésznek az aorta anatómiája mellett a patkóvese vérellátásáról és a húgyúti rendszerről. Az érsebészeti rekonstrukció esetén a transperitonealis feltárás – főleg akut műtét esetén – több előnnyel rendelkezik, mint a retroperitonealis feltárás. Orv Hetil. 2020; 161(46): 1966–1971. Summary. Horseshoe kidney is one of the most common congenital disorders of the kidney. The simultaneous incidence of horseshoe kidney and abdominal aneurysm is very low (0.12% of all cases of abdominal aortic aneurysm). In the first case, a 64-year-old male patient was admitted with acute lower limb ischaemia. CT-angiography revealed an occluded aortic aneurysm. During the emergency operation, the abdominal aneurysm was resected and an aortobifemoral bypass procedure was performed sparing the kidney’s isthmus. In the second case, the abdominal complaints were caused by an infrarenal abdominal aneurysm that involved both common iliac arteries. Aortobiiliac reconstruction was performed with planned separation of the kidney isthmus and reimplantation of the accessory renal artery. Symptomatic abdominal aortic aneurysm is an urgent indication for reconstruction. The preoperative CT- or MR-angiography play a key role in the indication and planning of the reconstruction. It is highly important for the vascular surgeon to have a clear picture of the blood supply of the horseshoe kidney and the urinary tract along with the anatomy of the aorta before the operation. The transperitoneal approach has several advantages over the retroperitoneal approach during vascular reconstruction surgery. Orv Hetil. 2020; 161(46): 1966–1971.

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Isolated right testicular pain for six days: an unusual presentation of occult abdominal aortic aneurysm leak

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x569406 ◽

2011 ◽

Vol 93 (4) ◽

pp. e1-e2 ◽

Cited By ~ 3

Author(s):

Rachael O Forsythe ◽

Victoria Lavin ◽

Simon CA Fraser ◽

Alan McNeill

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Case Reports ◽

Haemodynamic Instability ◽

Older Patient ◽

Testicular Pain ◽

Lower Back ◽

Abdominal Aortic ◽

History Of ◽

The Right

Abdominal aortic aneurysm (AAA) rupture commonly presents with abdominal or lower back pain and haemodynamic instability. There have been case reports of co-existing left testicular pain; however, very few cases describe right testicular pain as the sentinel symptom. We discuss the case of a 75-year-old man who presented to the on-call urologists with a 6-day history of right testicular pain. On examination, a painless AAA was detected. The patient was stable and a CT scan demonstrated a large AAA extending into the right iliac vessels, with suggestion of leakage. Attempted emergency repair was unsuccessful and the patient died in theatre. This atypical presentation of occult aneurysm leak highlights the need for clinical vigilance in the older patient with seemingly benign groin symptoms, including isolated right testicular pain.

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Abdominal aortic aneurysm screening programme

British Journal of Healthcare Assistants ◽

10.12968/bjha.2019.13.9.430 ◽

2019 ◽

Vol 13 (9) ◽

pp. 430-434

Author(s):

Ian Peate

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Abdominal Aorta ◽

Screening Programme ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Ultrasound Scan ◽

Abdominal Aneurysm ◽

Abdominal Aortic ◽

The Uk

This is the second article in a series of articles regarding screening programmes. In this article, an overview of the abdominal aorta is provided. The article also considers the abdominal aortic aneurysm screening programme. Aortic abdominal aneurysm is described. The majority of abdominal aortic aneurysms are asymptomatic; however, if there are any symptoms, these are explained. All four UK countries offer men aged 65 years and over a screening opportunity using an ultrasound scan, the fundamental aspects of abdominal aortic aneurysm screening programmes is offered. It is emphasised that screening is not mandatory in the UK; the man has a right to decline the invitation to attend any screening programme.

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