Experiences with Inflammatory Abdominal Aortic Aneurysms / 日本心臓血管外科学会雑誌

ABSTRACT

Among 232 patients undergoing repair for abdominal aortic aneurysms (AAA) during a 10-year period, 5 (2.2%) patients had evidence of inflammatory abdominal aortic aneurysms (IAAA). We examined their clinical course, laboratory, operative and histopathological findings, and considered possible correlations between their diagnosis and surgical treatment. Among these cases of IAAA, 2 patients complained of severe abdominal or back pain. The differential diagnosis from rupture of AAA was difficult in these cases. They also showed inflammatory signs in laboratory, operative and histopathological findings. Ultrasonography, computed tomography and magnetic resonance imaging appear to offer reliable means for diagnosing IAAA; In particular we could recognize the“Inflammatory mantle”in 3 cases, which indicated IAAA. In the surgical treatment, the presence of IAAA necessitates certain modifications in the surgical approach, in order to avoid injuring the retroperitoneal and abdominal structures. We could observe post-operative change in the thickness of the aortic wall, which decreases with time without anti-inflammatory agents.