Pseudoaneurysm of the abdominal aorta due to a needle-like osteophyte on the first lumbar vertebra Einar Dregelid, MD, Guttorm Jenssen, MD, Torbjörn.

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Pseudoaneurysm of the abdominal aorta due to a needle-like osteophyte on the first lumbar vertebra Einar Dregelid, MD, Guttorm Jenssen, MD, Torbjörn Jonung, PhD, MD, Audun Braaten, MD Journal of Vascular Surgery Volume 45, Issue 5, Pages 1059-1061 (May 2007) DOI: 10.1016/j.jvs.2006.12.070 Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 1 Admission computed tomography (CT) scan showed attenuation changes compatible with infiltration of blood retroperitoneally, into the mesenteric root and into the hepatic hilum. The CT density in the retroperitoneal collection between the aorta and the vertebral body is 45 HU, identical to that in the aortic lumen, whereas the density of the preaortal tissues is about 20 HU. Journal of Vascular Surgery 2007 45, 1059-1061DOI: (10.1016/j.jvs.2006.12.070) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 2 On the third day after admission, a contrast-enhanced computed tomography scan showed the crescent-shaped cavity of an aortic pseudoaneurysm, with a needle-thin perforation in the posterior wall of the aorta just opposite the origin of the superior mesenteric artery (oblique arrow). A 5-mm long needle-like osteophyte on the upper margin of the first lumbar vertebra (vertical arrow) was located just opposite the aortic perforation. Journal of Vascular Surgery 2007 45, 1059-1061DOI: (10.1016/j.jvs.2006.12.070) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 3 A contrast-enhanced computed tomography scan performed 14 days after admission showed that the pseudoaneurysm (P) had increased in size. The arrow points to aortic perforation. Journal of Vascular Surgery 2007 45, 1059-1061DOI: (10.1016/j.jvs.2006.12.070) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 4 The aorta (A) and pseudoaneurysm (P) were exposed via a thoracolaparotomy. The ninth intercostal space was used for access to the left pleural space. The aorta could be clamped obliquely just below the origin of the superior mesenteric artery (*). LR, Left renal artery. Journal of Vascular Surgery 2007 45, 1059-1061DOI: (10.1016/j.jvs.2006.12.070) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions