Tendoachilles reconstruction by a gastrosoleus turn-down flap: a case report

Acute and chronic rupture of the Achilles tendon (TA) is a common entity which requires surgery to either bridge the gap or to reinforce the strength of the repair or the tendon. This was done with a turn down flap of the gastrosoleus. Both the above conditions of acute and chronic rupture were usually misdiagnosed and mistreated. Hence, they presented to us late or with complications affecting the gait. Here, we presented a case of acute rupture of the TA presented late in a young female in which the defect was managed with a gastrosoleus aponeurosis turn down flap. Primary repair of acute TA rupture augmented with a gastrosoleus turn down flap provides a good outcome.

Vertebral erosion due to chronic rupture of aneurismatic abdominal aorta

Introduction. Extremely rarely, the evolution of abdominal aortic aneurysm (AAA) includes the phase when extravasations of the blood from a ruptured aneurysm is contained by the surrounding tissue, referred to as chronic (contained) rupture of the AAA. Our aim was to call attention to this life-threatening condition, which is always challenging for diagnosis. Case outline. A 58-year-old man reported to the Emergency Center for significant abdominal pain. Ultrasound examination showed an infrarenal aneurysm of the abdominal aorta. A computed tomography scan of the thorax, abdomen, and pelvis with iodine contrast in arterial phase was performed. A free gas collection was observed between the liver and the anterior abdominal wall that is traced to a ruptured inflamed diverticulum on the transversal colon. Immediately distal to the branching sites of the renal arteries, the abdominal aorta extended forward and aneurismatically expanded. Posterior left, along the psoas muscle, a rupture of the aortic wall was seen, with an organized hematoma that accompanied the muscle. Between the hematoma and the aortic aneurysm, erosions of the anterior and lateral part of the vertebral bodies L2 and L3 were discovered. The patient underwent endovascular AAA repair (EVAR) and recovered well. Conclusion. Multidetector computed tomography angiography is a reliable, non-invasive, and necessary examination for localization and evaluation of the size of the AAA form, its chronic rupture, and complications such as vertebral body erosion.