Ruptured Aortic Aneurysm Causing Right Hydronephrosis

Abstract

A 61-year-old man was admitted with right flank pain for 3 weeks. Physical examination revealed mild costovertebral angle tenderness in the right flank. Laboratory tests, including serum creatinine level, inflammatory markers (erythrocyte sedimentation rate, C-reactive protein), and urine analysis, were normal. Ultrasonography revealed significant right hydronephrosis with an abdominal aortic aneurysm. Computed tomography (CT) scan demonstrated a 12x7-cm ruptured fusiform abdominal aortic aneurysm (AAA) continuing from the aortic bifurcation to infrenally and causing right hydroureteronephrosis (Figure 1). After informed consent was obtained, the aortic aneurysm was treated endovascularly (endovascular aneurysm repair (EVAR)) with a “Y” stent. Double J catheter insertion for right hydronephrosis due to ureteral obstruction was performed (Figure 2, 3). A follow-up CT in the first month showed an aggravated aortic hematoma with completely resolved right hydronephrosis (Figure 4). A subgroup of aortic aneurysms is inflammatory type AAAs, representing about 10%. Genitourinary symptoms are more common Ruptured Aortic Aneurysm Causing Right Hydronephrosis