Spontaneous perforation of a non-aneurysmal atherosclerotic abdominal aorta or femoral artery

Abstract The spontaneous perforation of a non-aneurysmal atherosclerotic abdominal aorta or femoral artery is reported. Over the past 14 years, four perforations have been found in the abdominal aorta and one in the femoral artery; the incidence of each was 1.1% and 5.9%, respectively. Computed tomography scanning was useful for diagnosing pseudoaneurysms in all cases, since it revealed haematoma outside the arterial wall. One of these cases presented with an aortoduodenal fistula. The arteries were severely atherosclerotic with calcification. All of the patients underwent a graft replacement. Operative findings confirmed pseudoaneurysm. One patient died from pneumonia 4 months after the operation, and the other four have remained well during the follow-up period ranging from 2–9 years.