History

The patient is a 50-year-old man with a 6-month history of weight loss, abdominal pain, progressive right lower extremity claudication, and bilateral lower extremity and scrotal swelling. The patient also had a recent injury to his right leg, which resulted in osteomyelitis. A contrast-enhanced CT scan of the abdomen and pelvis was performed (Figure 1, Figure 2, Figure 3).

The patient underwent subsequent abdominal aortography. Selected images from a digital-subtraction mid-stream abdominal aortogram are shown in temporal sequence (Figure 4, Figure 5, Figure 6, Figure 7).