SURGICAL TREATMENT OF A SPONTANEOUS RUPTURE OF A MYCOTIC ANEURYSM

Authors

  • Pedro Pinto Sousa Service of Vascular Surgery, Centro Hospitalar Vila Nova de Gaia-Espinho, Portugal
  • Sérgio Teixeira Service of Vascular Surgery, Centro Hospitalar Universitário do Porto, Portugal
  • Rui Almeida Service of Vascular Surgery, Centro Hospitalar Universitário do Porto, Portugal
  • Pedro Sá Pinto Service of Vascular Surgery, Centro Hospitalar Universitário do Porto, Portugal

DOI:

https://doi.org/10.48729/pjctvs.200

Abstract

Saccular mycotic aorto-iliac aneurysms are rare but, when ruptured, they are an important life-threatening condition. We present the case of a 52 years-old male transferred from another hospital and admitted to the emergency room with a ruptured iliac artery aneurysm. He complained of persistent fever and abdominal discomfort that swiftly established as hemorrhagic shock. Image study with computed tomographic angiography revealed a ruptured left common iliac artery saccular aneurysm. The patient was instantaneously and successfully submitted to endoaneurismorraphy of the hypogastric artery, common and external iliac artery ligation and construction of an extra anatomic bypass, right to left femorofemoral bypass. Blood culture revealed a Streptococcus anginosus and the patient received appropriate targeted antibiotics. Post-operative period was uneventful and the patient discharged ten days after admission. He has now eleven months of follow up with no intercurrences. Even though surgical approach carries a relative risk of perioperative morbidity, it is a feasible and durable solution for extreme situations like the one here described.

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References

Sorelius K, Mani K, Bjorck M, et al. Endovascular treatment of mycotic aortic aneurysms: a European multicenter study. Circulation. 2014;130:2136–42. doi: 10.1161/CIRCULATIONAHA. 114.009481

Dubois M, Daenens K, Houthoofd S, Peetermans WE, Fourneau I. Treatment of mycotic aneurysms with involvement of the abdominal aorta: single-centre experience in 44 consecutive cases. Eur J Vasc Endovasc Surg. 2010;40:450–6. doi: 10.1016/j.ejvs.2010.07.017

Hyo-Hyun Kim, M.D., Do Jung Kim, M.D., and Hyun-Chel Joo, M.D.; Hyo-Hyun Kim, M.D., Do Jung Kim, M.D., and Hyun-Chel Joo, M.D. Korean J Thorac Cardiovasc Surg. 2017 Dec; 50(6): 430–435

Touma J, Cochennec F, Parisot J, et al. In situ reconstruction in native and prosthetic aortic infections using cryopreserved arterial allografts. Eur J Vasc Endovasc Surg. 2014;48:292–9. doi: 10.1016/j.ejvs.2014.04.023.

Muller BT, Wegener OR, Grabitz K, Pillny M, Thomas L, Sandmann W. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases. J Vasc Surg. 2001;33:106–13. doi: 10.1067/mva.2001.110356

Cina C.S., Arena G.O., Fiture A.O., Clase C.M., Doobay B. Ruptured mycotic thoracoabdominal aortic aneurysms: a report of three cases and a systematic review. J Vasc Surg. 2001;33:861–867

Fillmore AJ, Valentine RJ. Surgical mortality in patients with infected aortic aneurysms. J Am Coll Surg. 2003;196(3):435–41

Chang-Chih Tsai,1 Chien-Chin Hsu,2 and Kuo-Tai Chen; Infected aortic and iliac aneurysms: Clinical manifestations in the emergency departments of two hospitals in southern Taiwan, China; World J Emerg Med. 2017; 8(2): 121–125

Lee WK, Mossop PJ, Little AF, Fitt GJ, Vrazas JI, Hoang JK, et al. Infected (mycotic) aneurysms: spectrum of imaging appearances and management. Radiographics. 2008;28(7):1853–68

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Published

07-11-2021

How to Cite

1.
Pinto Sousa P, Teixeira S, Almeida R, Sá Pinto P. SURGICAL TREATMENT OF A SPONTANEOUS RUPTURE OF A MYCOTIC ANEURYSM. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Nov. 7 [cited 2024 May 22];28(3):63-5. Available from: https://pjctvs.com/index.php/journal/article/view/200

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Clinical Cases

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