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Ruptured abdominal aortic aneurysm masquerading as isolated hip pain: an unusual presentation

Published online by Cambridge University Press:  21 May 2015

Sriram Vaidyanathan ,
Himanshu Wadhawan ,
Pedro Welch  and
Murad El-Salamani
Sriram Vaidyanathan*
Affiliation:
Emergency Medicine, Bassetlaw District General Hospital, Nottinghamshire, UK
Himanshu Wadhawan
Affiliation:
Emergency Medicine, Bassetlaw District General Hospital, Nottinghamshire, UK
Pedro Welch
Affiliation:
Emergency Medicine, Bassetlaw District General Hospital, Nottinghamshire, UK
Murad El-Salamani
Affiliation:
Emergency Medicine, Bassetlaw District General Hospital, Nottinghamshire, UK
*
32 Wicklow Rd., Doncaster, South Yorkshire DN2 5LA, UK; [email protected]

Abstract

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The rupture of an abdominal aortic aneurysm (AAA) is a catastrophic event. Misdiagnosis by first-contact emergency physicians remains a serious concern. Varied and frequently nonspecific presentations lead to erroneous diagnostic impressions and cause significant delays in definitive intervention. We report the case of a 73-year-old man with a ruptured AAA presenting with isolated acute right hip pain without any classical features such as truncal pain or hypotension. Despite major advances in imaging and definitive treatment, a heightened awareness among emergency physicians remains the only effective means of improving detection and thereby survival.

Keywords

ruptured abdominal aoritc aneurysmdiagnosiscomputerized tomogrpahy scanacute hip pain
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 10 , Issue 3 , May 2008 , pp. 251 - 254
Copyright
Copyright © Canadian Association of Emergency Physicians 2008

References

1.Sakalihasan, N, Limet, R, Defawe, OD. Abdominal aortic aneurysm. Lancet 2005;365:1577–89.CrossRefGoogle ScholarPubMed
2.Hallett, JW Jr. Management of abdominal aortic aneurysms. Mayo Clin Proc 2000;75:395–9.CrossRefGoogle ScholarPubMed
3.Acosta, S, Ogren, M, Bengtsson, H, et al. Increasing incidence of ruptured abdominal aortic aneurysm: a population-based study. J Vasc Surg 2006;44:237–43.Google Scholar
4.Haro, LH, Krajicek, M, Lobl, K. Challenges, controversies and advances in aortic catastrophes. Emerg Med Clin North Am 2005;23:1159–77.CrossRefGoogle ScholarPubMed
5.Akkersdijk, GJ, Bockel, JHV. Ruptured abdominal aortic aneurysm: initial misdiagnosis and the effect on treatment. Eur J Surg 1998;164:29–34.Google Scholar
6.Acheson, AG, Graham, ANJ, Weir, C, et al. Prospective study on factors delaying surgery in rupturedabdominal aortic aneurysms. J R Coll Surg Edinb 1998;43:182–4.Google Scholar
7.Rose, J, Civil, I, Koelmeyer, T, et al. Ruptured abdominal aortic aneurysms: clinical presentation in Auckland 1993–1997. ANZ J Surg 2001;71:341–4.CrossRefGoogle ScholarPubMed
8.Contini, S, McMaster, P. Abdominal aortic aneurysm — the forgotten diagnosis? Postgrad Med J 1980;56:102–5.CrossRefGoogle ScholarPubMed
9.Ijaz, S, Geroulakos, G. Ruptured internal iliac aneurysm mimicking a hip fracture. Int Angiol 2001;20:187–9.Google Scholar
10.Walker, A, Brenchley, J, Sloan, JP, et al. Ultrasound by emergency physicians to detect abdominal aortic aneurysms: a UK case series. Emerg Med J 2004;21:257–9.Google Scholar
11.Goldberg, BB. Aortosonography. Int Surg 1977;62:294–7.Google Scholar
12.Lloyd, GM, Bown, MJ, Norwood, MG, et al. Feasibility of preoperative computer tomography in patients with ruptured aortic aneurysm: a time-to-death study in patients without operation. J Vasc Surg 1995;21:656–69.Google Scholar
13.Hinchliffe, RJ, Bruijstens, L, MacSweeney, STR, et al. A randomised trial of endovascular and opensurgery for ruptured abdominal aortic aneurysm- results of a pilot study and lessons learned for future studies. Eur J Vasc Endovasc Surg 2006;32:506–13.Google Scholar
14.Hinchliffe, RJ, Yusuf, SW, Macierewicz, JA, et al. Endovascular repair of ruptured abdominal aortic aneurysm — a challenge to open repair? Results of a single centre experience in 20 patients. Eur J Vasc Endovasc Surg 2001;22:528–34.Google Scholar
15.Fitzgerald, EJ, Spence, LD. Pre-operative computed tomography in abdominalaortic aneurysms. Postgrad Med J 1996;72:484–6.CrossRefGoogle Scholar
16.Mehta, M, Taggert, J, Darling, C, et al. Establishing a protocol for endovascular treatment of ruptured abdominal aortic aneurysms: outcomes of a prospective analysis. J Vasc Surg 2006;44:1–8.CrossRefGoogle ScholarPubMed
17.Boyle, JR, Gibbs, PJ, Kruger, A, et al. Existing delays following the presentation of abdominal aortic aneurysm allow sufficient time to assess patients for endovascular surgery. Eur J Vasc Endovasc Surg 2005;29:505–9.Google Scholar
18.Acosta, S, Lindblad, B, Zdanowski, Z. Predictors of outcome after open and endovascular repair of ruptured aortic aneurysms. Eur J Vasc Endovasc Surg 2007;33:277–84.Google Scholar
19.Bentz, S, Jones, J. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. Accuracy of emergency department ultrasound scanning in detecting abdominal aortic aneurysm. Emerg Med J 2006;23:803–4.Google Scholar