Mycotic Aortic Aneurysm As A Rare Case Of Constipation And Weight Loss

Authors

  • Carolina Chálim Rebelo Gastroenterology Department, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal https://orcid.org/0000-0002-1268-4687
  • Diogo Bernardo Moura Gastroenterology Department, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal https://orcid.org/0000-0002-8353-4619
  • Vera Costa Santos Gastroenterology Department, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal
  • José Renato Pereira Gastroenterology Department, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal
  • Maria Antónia Duarte Gastroenterology Department, Hospital do Divino Espírito Santo de Ponta Delgada, Ponta Delgada, Portugal https://orcid.org/0000-0002-0922-1542

DOI:

https://doi.org/10.48729/pjctvs.241

Keywords:

mycotic aortic aneurysm, constitutional syndrome, aortoduodenal fistula, EVAR

Abstract

Mycotic aortic aneurysm is a rare entity, manifesting with nonspecific symptoms of abdominal pain, fever, general malaise.

We present a case of an 83-years-old-man, with hematemesis, generalized abdominal pain, and a six-month history of constipation, anorexia, and involuntary weight loss. Upper endoscopy revealed an erosion with oozing hemorrhage and hemostasis was performed. Later he developed a hemorrhagic shock. Abdominal computed tomography disclosed a 3,7x2,5x- 2,5cm aneurysm of the abdominal aorta with an aortoduodenal fistula, inducing an inflammatory plastron that encompassed the descending colon and duodenum. The inflammatory plastron prompted partial duodenal and colonic obstruction and led to an atypical presentation of an aortic aneurysm.

Mycotic aneurysms complicated with aorto-enteric fistulas are potentially life-threatening conditions. We highlight the rarity of this case, as the clinical manifestations were prolonged and atypical. The goal is to drive awareness to maintain a high clinical suspicion, as early detection is critical to avoid a tragic outcome.

Downloads

Download data is not yet available.

References

Sörelius K, Budtz-Lilly J, Mani K, Wanhainen A. Systematic Review of the Management of Mycotic Aortic Aneurysms. Eur J Vasc Endovasc Surg [Internet]. 2019;58(3):426–35. Available from: https://doi. org/10.1016/j.ejvs.2019.05.004

Müller 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(1):106 –13.

Fisk M, Peck LF, Miyagi K, Steward MJ, Lee SF, Macrae MB, et al. Mycotic aneurysms: A case report, clinical re- view and novel imaging strategy. Qjm. 2012;105(2):181–8

Lee SM, Lai YK, Wen WD. Aortoenteric fistula secondary to an inflammatory abdominal aortic aneurysm. J Radiol Case Rep. 2019 Sep;13(9):8–27.

Varghese M, Jorgensen GT, Aune C, Bergan R, Norderval S, Moland J. Primary aortoduodenal fistula - A case report and a review of the literature. Ann Vasc Surg [Internet]. 2016;34:271.e1-271.e4. Available from: http://dx.doi.org/10.1016/j.avsg.2015.12.013

Li PS, Tsai CL, Hu SY, Lin TC, Chang YT. Spontaneous hemothorax caused by ruptured multiple mycotic aortic aneurysms: A case report and literature review. J Cardiothorac Surg. 2017;12(1):10–3.

Lew WK, Rowe VL, Cunningham MJ, Weaver FA. Endovascular Management of Mycotic Aortic Aneurysms and Associated Aortoaerodigestive Fistulas. Ann Vasc Surg [Internet]. 2009;23(1):81–9. Available from: http://dx. doi.org/10.1016/j.avsg.2008.08.008

Dick J, Tiwari A, Menon J, Hamilton G. Abdominal Aortic Aneurysm Secondary to Infection With Pseudomonas aeruginosa: A Rare Cause of Mycotic Aneurysm. Ann Vasc Surg [Internet]. 2010;24(5):692.e1-692.e4. Avail- able from: http://dx.doi.org/10.1016/j.avsg.2010.02.003

Vallejo N, Picardo NE, Bourke P, Bicknell C, Cheshire NJW, Jenkins MP, et al. The changing management of primary mycotic aortic aneurysms. J Vasc Surg. 2011 Aug;54(2):334–40.

Lopes RJ, Almeida J, Dias PJ, Pinho P, Maciel MJ. Infectious thoracic aortitis: a literature review. Clin Cardiol. 2009 Sep;32(9):488–90.

Downloads

Published

14-01-2023

How to Cite

1.
Chálim Rebelo C, Moura DB, Costa Santos V, Pereira JR, Duarte MA. Mycotic Aortic Aneurysm As A Rare Case Of Constipation And Weight Loss. Rev Port Cir Cardiotorac Vasc [Internet]. 2023 Jan. 14 [cited 2023 Feb. 3];29(4):65-7. Available from: https://pjctvs.com/index.php/journal/article/view/241

Issue

Section

Clinical Cases

Categories