Giant Iliac Artery Pseudoaneurysm Mimicking Postoperative Fluid Collection and Diskitis.
Aneurysm
Lumbar surgery
Postoperative spine
Pseudoaneurysm
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
09
09
2019
revised:
29
11
2019
accepted:
30
11
2019
pubmed:
10
12
2019
medline:
9
4
2020
entrez:
10
12
2019
Statut:
ppublish
Résumé
In this report, we describe an extremely rare case of a giant pseudoaneurysm of the internal iliac artery causing marked destructive changes at a disk space and mimicking diskitis-osteomyelitis. Only 2 other cases of pseudoaneurysms extending into the disk space have been reported, and those arose from the aorta and were relatively straightforward to diagnose. Our case is unique because the pseudoaneurysm arose from the internal iliac artery, an artery that is not usually included in the field of view of lumbar magnetic resonance imaging or computed tomography. However, the pseudoaneurysm was so large that it extended to the lumbosacral junction, where it eroded a disk space and caused findings of diskitis-osteomyelitis. Complex paraspinal fluid collections causing osseous erosions should raise the possibility of an aneurysm/pseudoaneurysm. Computed tomography or conventional angiography should be considered if the question of a vascular mass/collection cannot be answered on conventional cross-sectional imaging, as inadvertent biopsy of a pseudoaneurysm can cause catastrophic bleeding.
Sections du résumé
BACKGROUND
BACKGROUND
In this report, we describe an extremely rare case of a giant pseudoaneurysm of the internal iliac artery causing marked destructive changes at a disk space and mimicking diskitis-osteomyelitis. Only 2 other cases of pseudoaneurysms extending into the disk space have been reported, and those arose from the aorta and were relatively straightforward to diagnose.
CASE DESCRIPTION
METHODS
Our case is unique because the pseudoaneurysm arose from the internal iliac artery, an artery that is not usually included in the field of view of lumbar magnetic resonance imaging or computed tomography. However, the pseudoaneurysm was so large that it extended to the lumbosacral junction, where it eroded a disk space and caused findings of diskitis-osteomyelitis.
CONCLUSIONS
CONCLUSIONS
Complex paraspinal fluid collections causing osseous erosions should raise the possibility of an aneurysm/pseudoaneurysm. Computed tomography or conventional angiography should be considered if the question of a vascular mass/collection cannot be answered on conventional cross-sectional imaging, as inadvertent biopsy of a pseudoaneurysm can cause catastrophic bleeding.
Identifiants
pubmed: 31816453
pii: S1878-8750(19)33026-8
doi: 10.1016/j.wneu.2019.11.176
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
253-257Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.