Multiple Arterial Aneurysms in Cerebral Palsy Patient

ABSTRACT

A 36-year-old man presented abrupt onset of epigastric pain with high fever for one week after pork meal. Extensive diagnostic studies including blood, urine and stool cultures and other inflammatory factors were done but only leukocytosis, 1160 for H Ag of widal test, and increased FDP were positive findings. Abdominal CT showed multifocal hepatic and splenic arterial aneurysms which grew very rapidly during these 10 days. Emergency exploration and ligation at either side of common hepatic artery and the proximal segment of right hepatic artery were done because of impending rupture. The histologic findings of the excised aneurysmal wall were diffuse infiltration of inflammatory cells and medial necrosis. Several other arterial aneurysms at right brachial, left carotid and branch of superior mesenteric artery were identified on the follow up angiogram. Also noted right brachial artery thrombosis in aneurysmal dilatation site and this was treated by continuous intraarterial infusion of urokinase. Even though the patient had no endocarditis and no growth of blood culture, we consider this multiple artery aneurysms as an infected aneurysm by unknown bacteremia due to pork meal.