Preventive Medicine - BJSTR Journal

Abstract

Our patient presented with symptoms resembling acute appendicitis, during #diagnostic laprascopy a #retroperitoneal hematoma without palpable Aneurysm was found, because the patient was hemodynamically stable. It was decided to carry out further #radiological investigations, a computed tomography revealed a right sided solitary iliac artery aneurysm and a retroperitoneal hematoma and because we were sure about the diagnosis endovascular reconstruction was done, patient recovered nicely, and the retroperitoneal hematoma was reabsorbed spontaneously, and patient was Send home after 7 days. 40 years male patient was presented to the emergency department complaining from pain at the #right iliac fossa area for the last 48 hours. On clinical examination there was right lower quadrant peritonitis with no palpable mass, body temperature was 37.8 c and the patient #leukocytosis was 18000, ultrasound was done, and it was not conclusive because of dilated loops of bowel, rebound tenderness was positive, psoas sign was positive. Acute appendicitis was suspected, and laparoscopic appendectomy was planned to be done under general anesthesia. The view was poor and a decision of laparotomy to be done is taken at the same session. There was a normal appendix and a retroperitoneal hematoma on the lateral side of the cecum. The retroperitoneal hematoma was pulsating, and it was a very clear vascular problem, since the patient was hemodynamically stable the operation was terminated with the diagnosis of retroperitoneal hematoma which needs further investigations postoperative CT scan (Figures 1-3) showed a right iliac artery aneurysm with the diameter or 4cm and a retroperitoneal #hematoma. As with aortic aneurysms size seems to be the most important determinant.

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Iliac #ArteryAneurysum as Differential Diagnosis of Right Iliacfossa Pain by Faris Alaswad in BJSTR