A case of multiple tuberculous aneurysm of the abdominal aorta / 北京大学学报(医学版)

ABSTRACT

SUMMARY Tuberculous aneurysm of the aorta is a very rare disorder. There have been only 50 reported cases of tuberculous aneurysm since 1895 till now, of which 88% were false aneurysms with majority being single in number. And only four were found to have multiple tuberculous aneurysms. The mean ages of the patients were 50?16 years. Treatment of tuberculous aortic aneurysm must be a combined medical and surgical approach. Once tuberculous aneurysm is identified, surgery must be performed promptly. The size of the aneurysm does not influence the need for surgery. A 70-year-old male with intermittent episodes of abdominal pain after receiving an inappropriate antitubercular therapy for pulmonary tuberculosis was diagnosed as multiple false tubercular aneurysm of abdominal aorta. An aneurysm of base 3.3 cm and greatest diameter 5 cm?6 cm was seen just above the opening of Coeliac trunk. Also at the dorsal aspect of abdominal aorta and superior mesenteric artery junction and ventral aspect of renal artery false aneurysms were seen, each with the size of 1 cm in diameter. Apart from antitubercular and antimicrobial treatment, first line surgery Endovascular Exclusion of Abdominal Aortic Aneurysm was performed for ruptured false abdominal aortic aneurysm. Even before the second line surgery, smaller abdominal aortic aneurysms got ruptured and the patient ’s party gave up further treatment. Finally the patient died of gastrointestinal haemorrhage.