[Differential diagnosis of jaundice and fever of unknown origin: ruptured aortic aneurysm with obstruction of the bile ducts].
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Abstract
A 65-year-old man with fever of unknown origin developed progressive extrahepatic cholestasis. Radiological examination documented a suprarenal abdominal aortic aneurysm. Fatal intraabdominal bleeding occurred, leading to death. Post-mortem examination revealed an earlier retroperitoneal rupture of the aortic aneurysm and massive perianeurysmal inflammation. The blood masses, reaching the porta hepatis, caused progressive obstruction of the extrahepatic bile ducts. Surgical treatment, delayed because of cholestatic and febrile complications, could have prevented the outcome.