Intermittent aortic-graft obstruction secondary to anastomotic aneurysms
C. J. McCabe, D. C. Brewster and R. C. Darling
Diagnosis of anastomotic aneurysms is usually suggested by simple palpation
of a pulsatile mass on physical examination. Diagnosis may be more
difficult, and clinical appearance more unusual, for those aneurysms
occurring in an intra-abdominal location. This article reports an unusual
manifestation of bilateral iliac-artery false aneurysms, ie, intermittent
obstruction of aortic-graft blood flow. Femoral pulses were absent and
significant peripheral ischemia present with the patient's legs extended.
Femoral pulses returned to normal with the patient's legs flexed.
Perianastomotic fibrosis, the mass effect of the false aneurysms, and
possible kinking of the partially disrupted suture line with tensing of the
psoas muscle on extension of the legs are possible causes of the
intermittent obstruction to blood flow. The varied clinical manifestations
and general principles of operative repair of anastomotic aneurysms are
described.
