Day 2 - Case 7

Begoña Márquez, Ana Blanco Barrio
Department of Radiology, HU Morales Meseguer, Murcia, Spain

Clinical history:
A 68-year-old male presented to the emergency department with rectorrhagia. A colonoscopy was performed showing fresh blood with clots in the right colon and active bleeding coming from the appendiceal base. Patient had a history of open repair of an infrarenal aortic aneurysm 4 years prior. On examination: tachycardia, hypotension.

Possible answers
  • Aortic graft rupture into the cecum
  • Mycotic aneurysm penetrating the appendiceal wall with active bleeding
  • Acute appendicitis complicated with periaortic abscess
  • Infected graft with pseudoaneurysm formation penetrating the appendiceal wall
  • Postsurgical fibrosis penetrating the appendiceal wall

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