case_images: PMC10467229_01
case_images: CT scan (a) showing significant biliary ductal dilation. (b) Demonstrating abdominal aortic aneurysm with separated left iliac stent consistent with a Type III endoleak.
case_images: 10.1177_2050313X231194143-fig1.jpg
case_images: PMC10467229_01_10.1177_2050313X231194143-fig1.jpg
case_images: fig1-2050313X231194143
case_images: A CT scan of the abdomen and pelvis with intravenous contrast was completed confirming the sonographic findings as displayed in Figure 1(a). A large Type III endoleak of her aorto-iliac endograft secondary to a complete disconnect of the left iliac limb was also discovered, with a maximum aortic sac diameter of 6.1 x 6.0 cm as shown in Figure 1(b).
case_images: ERCP, imaging of common bile duct; consistent with a distal stricture.. ERCP: endoscopic retrograde cholangiopancreatography.
case_images: 10.1177_2050313X231194143-fig2.jpg
case_images: PMC10467229_01_10.1177_2050313X231194143-fig2.jpg
case_images: fig2-2050313X231194143
case_images: The ERCP revealed a distal CBD stricture measuring 3 mm in length located 2 cm above the ampullary orifice with cystic dilation suggesting a Type III choledochal cyst demonstrated in Figure 2.
case_images: (a) Aortography demonstrating the Type III endoleak by showing contrast going into the aneurysm sac. (b) Completion aortogram showing preservation of renal arteries and no endoleaks.
case_images: 10.1177_2050313X231194143-fig3.jpg
case_images: PMC10467229_01_10.1177_2050313X231194143-fig3.jpg
case_images: fig3-2050313X231194143
case_images: Next, the vascular surgical team performed an aortography via access from the right femoral artery which demonstrated extravasation of contrast into the aneurysm sac, as can be seen in Figure 3(a). A complete aortography was performed that revealed satisfactory placement with visualization of the renal arteries, complete exclusion of the aortic sac, and no endoleaks, as shown in Figure 3(b).