Abdominal aortic aneurysm presenting in a patient with type 2 diabetes mellitus - A case report

Abstract

Background: The occurrence of an abdominal aortic aneurysm (AAA) in a patient is associated with significant risk of mortality from sudden rupture of the aneurysm. The development of abdominal aortic aneurysm in type 2 diabetes mellitus is a very rare event because diabetes mellitus has a protective role in preventing the development of abdominal aortic aneurysm.

Objective: To present a rare occurrence of abdominal aortic aneurysm in a type 2 diabetic patient.

Methods: Clinical and sonographic evaluation of a 68 year old male Nigerian, known to have type 2 diabetes mellitus was done. Other investigations carried out included fasting serum lipid profile, casual blood glucose, serum electrolytes, urea and creatinine, and urinalysis.

Results: There was a 5-month history of abdominal swelling, progressive weight loss, polyuria and polyphagia. Physical examination revealed a superficial, non tender, pulsatile and expansile abdominal mass which was confirmed on ultrasonography to be an abdominal aortic aneurysm. Casual blood glucose was markedly elevated (>600 mg/dl) and there was ketonuria andhypercholesterolaemia. He was treated for diabetic ketoacidosis with the usual protocol and was placed on simvastatin for hypercholesterolaemia. The AAA is being treated conservatively with beta-blockers along with monthly serial sonographic monitoring of AAA.

Conclusion: Abdominal aortic aneurysm is a very rare occurrence in type 2 diabetes mellitus that is potentially fatal if it ruptures. Early sonographic evaluation of a pulsatile abdominal mass in diabetic patients is thus recommended for early diagnosis and treatment.