17 days later. Intervening surgery
Endovascular repair of infra-renal abdominal aortic aneurysm.
Supra renal abdominal aorta, both renal arteries, coeliac trunk, superior and inferior mesenteric artery and all their major branches outline normally with contrast.
The lumen of endovascular repaired infrarenal abdominal aorta adequately enhances. Focal blush of contrast posterior to the right limb of the abdominal aortic stent before it extends into the right iliac vessels (at L3/L4 level ) in keeping with an endoleak in the aneurysmal sac. This blush is not apparent on the non contrast study.
Stable appearing abdominal aortic aneurysm approximately measures 6.0 cm in AP diameter. The walls of the aneurysm are still thickened in keeping with the known inflammatory aneurysm.
Both common iliac, internal and external iliac arteries outline normally with contrast.
Hepatic cyst. Stable appearing well-defined cyst in the pancreatic head.
Both adrenals, kidneys, gallbladder outline normally with contrast.
No intestinal obstruction/pneumoperitoneum. Moderate volume free fluid in the pelvis.
Background centrilobular emphysema. Bilateral mild pleural effusions with atelectatic bands at both lung bases. Main airways are clear. No pericardial effusion.
Ill-defined peripheral ground glass patchy opacification is noted in the right lower and middle lobe. Multi-level, multi-station, small volume mediastinal lymph nodes.
No suspicious osseous lesion noted in the visualised skeleton.
Comment: Type II endoleak posteriorly in the sac just above the bifurcation.