Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature.

PURPOSE

To assess the CT features of sealed rupture of abdominal aortic aneurysm.

PATIENTS AND METHODS

We reviewed the CT scans of six index cases obtained over a 3 year period with a sealed rupture of an abdominal aortic aneurysm and those reported in the literature over a 21 year period. CT scans were reviewed for aneurysm size, the presence of a draped aorta and adjacent vertebral erosion. A group of consecutive patients with non-ruptured abdominal aortic aneurysm, referred for endovascular aneurysm repair during the same 3 year period constituted the control group.

RESULTS

In the study group of 31 patients the mean size of the aneurysm was 6.24 +/- 2.01 cm, compared to 6.01 +/- 0.99 cm in the control group, without statistically significant difference (t = 0.75, df = 97, P = 0.46). A draped aorta was detected in all patients with a sealed rupture. Vertebral erosion was present in all our six, but mentioned in only 14 of the cases reported.

CONCLUSION

A sealed rupture of an abdominal aortic aneurysm can occur in relatively small aneurysms. A draped aorta and adjacent vertebral erosion are characteristic CT signs of such a rupture.