[False anastomotic iliac aneurysms. How to detect them?]. / Les faux anévrismes anastomotiques iliaques. Comment les dépister?

We report about 5 iliac anastomotic false aneurysms that occurred in 4 patients 8 to 21 years (average 15.5 years) after aortoiliac prosthetic reconstruction. The diagnosis was not established at once because of atypical clinical signs, in spite of the constant presence of an abdominal pulsating mass. All patients were operated by portal excision and graft replacement. One patient, who had presented with a hypovolemic collapse due to an acute rupture, died. The incidence of iliac false aneurysms after aortoiliac reconstructions is underestimated because the clinical surveillance is not reliable. The analysis of the explorations that were proposed led to prefer computed tomography to ultrasonography and angiography. The period of occurrence of iliac false aneurysms ranges between 6 to 10 years in average after the first operation. We therefore propose to perform a systematic follow-up CT examination on the 5th postoperative year, then every 5 years, and to operate the iliac false aneurysms as soon as their diagnosis is made.

[Aneurysm of the subrenal abdominal aorta spontaneously rupturing into the inferior vena cava]. / Anévrysme de l'aorte abdominale sous-rénale spontanément rompu dans la veine cave inférieure.

The authors report a new case of spontaneous rupture of an infrarenal abdominal aortic aneurysm into the inferior vena cava operated with a good haemodynamic result. However, the patient died of multiple postoperative complications and an associated left bronchopulmonary carcinoma. The following features are emphasised: the contribution of complementary investigations to the diagnosis of this condition: abdominal ultrasonography, aortography and above all, especially in future years, of digitised angiography; the clinical importance of ischaemia of the descending colon and acute postoperative renal failure, the prevention of which should improve surgical results.