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Case Reports
. 2022 Jul:96:107288.
doi: 10.1016/j.ijscr.2022.107288. Epub 2022 Jun 7.

Ruptured abdominal aortic aneurysm treated with open surgical repair (OSR) of a patient with active COVID-19 infection: A case report

Tareq H Al-Samarneh  1 , Kristi E Janho  1 , Muhannad O Jalokh  1 , Rami A Abudayyeh  2 , Mohammad A Al-Doud  3 , Bashar K Anakrih  1
Affiliations
Case Reports

Ruptured abdominal aortic aneurysm treated with open surgical repair (OSR) of a patient with active COVID-19 infection: A case report

Tareq H Al-Samarneh et al. Int J Surg Case Rep. 2022 Jul.

Abstract

Introduction and importance: Patients continued to present vascular emergencies during the most severe phase of the COVID-19 outbreak. An abdominal aortic aneurysm rupture was considered the most life-threatening condition.

Aim: To report a case report of a patient with active COVID-19 infection presenting as a ruptured abdominal aorta aneurysm and treated with open surgical repair at the Department of Vascular Surgery, Royal Jordanian Medical Services (JRMS), Amman, Jordan.

Case presentation: A 69-year-old male presented with an active COVID-19 pneumonic chest infection. Abdominal CT of angiography showed a 4.8-cm infrarenal abdominal aortic aneurysm unsuitable for endovascular aortic aneurysm repair (EVAR). After a rapid deterioration in his general condition, he underwent an exploratory laparotomy which revealed the diagnosis of an AAA rupture. We managed his condition operatively with repair using a tube Dacron graft.

Clinical discussion: Ruptured AAA is considered a devastating lethal vascular emergency with high mortality and morbidity rates and needs emergency intervention n eligible patients. COVID-19 patients with AAA rupture have a significantly increased risk of intervention and require special attention regarding the type of intervention and anaesthesia. The COVID-19 pandemic has changed many guidelines in management vascular emergencies, among them AAA rupture patients. The National Societies guidelines recommended limiting interventions to emergencies only.

Conclusion: The difficulties of surgical intervention, anaesthesia and the appropriate intervention selection increase the burden on the medical staff resisting the obstacles imposed on them by COVID-19 infection.

Keywords: Abdominal aortic aneurysm; COVID-19 infection; Open surgical repair; Rupture.

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Conflict of interest statement

None of the authors have conflicts of interest.

Figures

Fig. 1
Fig. 1
Selected images of abdominal computed tomography angiography (CTA): showing 4.8 cm infrarenal abdominal aortic aneurysm with fat stranding.
Fig. 2
Fig. 2
Intra operative photos demonstrating central retroperitoneal hematoma caused by ruptured AAA.
Fig. 3
Fig. 3
Intra operative photos demonstrating open surgical repair of AAA using straight Dacron tube 18 mm graft.
See this image and copyright information in PMC

References

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