Association of Intra-Abdominal Pathologies and Vascular Anomalies with Infrarenal Aortic Aneurysm: A Computed Tomographic Study

The prevalence of potentially significant intra-abdominal pathologies or vascular anomalies in candidates for infrarenal aortic aneurysm repair remains unclear. This study retrospectively reviewed 130 consecutive patients with aortic aneurysms (4.5–10.0 cm in largest diameter) who had undergone contrast-enhanced abdominal computed tomography. The overall incidence of potentially significant pathologies was 31.5%. Gallstones were detected in 25 patients (19.2%). adrenal masses in six (4.6%), pancreatic tumors in two (1.5%), renal stones in two (1.5%), liver metastases in one (0.8%), retroperitoneal lymphoma in one (0.8%) and left gastric artery aneurysm in one (0.8%). Other pathologies included renal cysts in 42 patients (32.3%), colonic diverticulosis in nine (6.9%) and hepatic cysts in three (2.3%). Major vascular anomalies were encountered in only three of the 130 patients (2.3%) and these included two with a left-sided inferior vena cava and one case of retroaortic left renal vein. This study emphasizes the high incidence of potentially significant intra-abdominal pathologies and the low incidence of major vascular anomalies associated with infrarenal aortic aneurysm. The impact of such findings on the management of aortic aneurysms is discussed.