A Case of Successful Surgical Treatment for Ruptured Abdominal Aortic Aneurysm Due to Bacterial Infection / 日本心臓血管外科学会雑誌

ABSTRACT

A case of successful surgical treatment for a ruptured infected aneurysm of the abdominal aorta is presented. A 63-year-old man was admitted with a history of persistent fever of unknown cause and lumbago. During medical treatment, a new abdominal pulsatile mass was revealed on physical examination. Leucocytosis and elevation of C-reactive protein were demonstrated. Abdominal echogram and CT scan showed a ruptured aneurysm of the abdominal aorta. Ruptured infected aneurysm of abdominal aorta was diagnosed, and an emergency operation was performed. We found a tight inflammatory adhesion around the aneurysm, but there was no abcess formation. The aneurysm had the mural thrombi and necrotic tissue. As usual infected tissue was removed as possible with aneurysmectomy, and an artificial graft was replaced. The culture of the aneurysmal wall tissue was negative, but the infiltration of the inflammatory cells, mainly neutrophilic segmented leukocytes, were found on pathological examination. He is doing well without recurrent infection at 8 months after operation. Twenty five cases of infected abdominal aortic aneurysm (AAA) were reported in Japan, and 21 cases of them received surgical treatment. Management of infected AAA is discussed.