A 78-Year-Old Man With a Previously Stable Atherosclerotic Abdominal Aortic Aneurysm Presenting With Impending Rupture Following COVID-19.
Takeru Hori, Daigoro Hirohama, Ken Kaseda et al.
✦ AI-curated · Sources linked
Case in brief
A 78-year-old man with a surveilled atherosclerotic abdominal aortic aneurysm (AAA), stable at approximately 43 mm for 2 years, developed COVID-19. During admission for recurrent fever, cough, and poor appetite, his C-reactive protein rose again and mild low back pain appeared, without hemodynamic instability. Non-contrast computed tomography 18 days after COVID-19 diagnosis showed enlargement from 43 mm to 51 mm within 2 months and periaortic fat stranding, indicating impending rupture. Urgent endovascular aneurysm repair was performed before deterioration; he recovered without ischemic or procedural complications.
What made this case unusual
The previously stable, 43-mm AAA rapidly enlarged with periaortic inflammatory change after recent COVID-19, despite only mild back pain and no hemodynamic instability.
Diagnostic / clinical pearl
In a patient with a known AAA, a renewed rise in inflammatory markers or new symptoms may warrant repeat imaging, even when symptoms are mild and hemodynamics remain stable.