Ruptured inguinal aneurysm misdiagnosed as a groin hernia

Ruptured inguinal aneurysm misdiagnosed as groin hernia Anastomotic aneurysms observed with an incidence of 0.5% to 5.0% are consid ered a known complication following arterial surgery: especially when fabri c grafts in the inguinal region are implanted. An anecdotal report is prese nted describing a 64-year old male patient, who developed, 10 years followi ng an autologous femoro-tibial vein graft, a huge mass in the left groin. T he lesion,was considered an incarcerated inguinal hernia and the patient wa s admitted to the Department of Surgery for emergency repair: Clinical Exam ination, duplex sonography and CT scan clarified the diagnosis of an aneury sm with a diameter of 13 cm. The aneurysm was resected and a femoro-profund al vein graft M as implanted orthotopically the graft was covered with a sa rtorius muscle flap. The postoperative course was uneventful. The diagnosis is suspected by clinical examination and usually confirmed by duplex-sonog raphy The exact etiology of suture line aneurysms is unknown; in the presen t case progression of the underlying arteriosclerotic arterial disease afte r a follow lcp of 10 pears is likely For the treatment the usual methods of complicated aneurysm repair and preservation of the arterial circulation - using autologuous in situ methods or extraanatomic bypass grafts - with ad ditional biologic coverage are at hand.