Urgencia vital en paciente con Covid-19 por aneurisma abdominal con ruptura contenida: Reporte de caso y revisión de la literatura

Introduction Abdominal aortic aneurysms are dilatations of a segment of the vascular wall and are classified as surgical when they are greater than 5 cm in diameter. In 90% of cases they are located between the renal artery and the aortoiliac bifurcation. Mortality can reach 70-90% when it ruptures, so it is a surgical emergency. For this reason, we present the case of a patient with covid-19 infection who was concomitantly diagnosed with an abdominal aneurysm with contained rupture, for which it was treated as a vital emergency. Clinical case This is a 78-year-old male patient with no significant history, who presented a clinical picture of chest pain radiating to the left arm, associated with nausea, diaphoresis, and syncope. On physical examination, he reported long-standing left lumbar pain. On admission with normal EKG and troponins, he blood count with hemoglobin anemia of 9.8 mg/dl and positive covid pcr. In urinary tract tomography and thoraco-abdominal angiotomography with 3D reconstruction, the image of an abdominal aneurysm measuring 73 x 68 mm in transverse and anteroposterior diameter, with a length of 79 mm, with contained rupture, was evidenced as an incidental finding. It was classified as a vital emergency despite the Covid-19 infection and was operated on endovascularly. After 14 days of isolation, he was discharged. Conclusions Abdominal aneurysms with findings suggestive of rupture on diagnostic images should be classified as a vital emergency, due to their high mortality, and therefore surgical intervention should be performed immediately regardless of the underlying pathologies. Keywords: Abdominal Aortic Aneurysm; Ruptured Aneurysm; Coronavirus infections; Endovascular Procedures; Mortality