Abdominal pulsatile tumor after endovascular abdominal aortic aneurysm repair

A 70 years old patient was successfully treated for infrarenal aortic aneur ysm by an endovascular bifurcated prosthesis. Three months later because of dysuria, he underwent urological examination revealing an abdominal pulsat ile tumor. Thereafter the patient was sent to our emergency ward with suspe cted symptomatical endoleak. Radiological screening by computer tomography and magnetic resonance angiography, showed good post-operative results with out endoleak. Patient was treated with antispasmodic medication and is doin g well today. Because endovascular repair of aortic aneurysm, in contrast to an open appr oach, does not eliminate the aneurysm itself; post-operative abdominal palp ation can be ambigous. Magnetic resonance angiography - without the need of nephrotoxic contrast medium - compares favourabely to CT and provides exce llent pictures with less artefacts for post-operative screening of endoleak . If reperfusion can be excluded, pulsation is doe to the transmission of t he blood-pressure wave to the thrombosed aneurysm.