J.Jpn. Surg. Soc.. 90(8): 1274-1277, 1989
Case report
MYCOTIC ABDOMINAL ANEURYSM REQUIRING EMERGENCY OPERATION DUE TO SUDDEN THROMBOTIC BSTRUCTION : A CASE REPORT
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Departments of Surgery, Koga Hospital, Fukuoka, Japan Sakae Enomoto, Keiichi Horita, Kouzou Naitoh, Nobuhiko Koga*), Hitoshi Ohteki**), Tsuyoshi Itoh**) |
Abdominal ultrasonography, CT and MRI revealed an abdominal aneurysm within wihch there was an intimal flap and thrombus. Though blood culture was not positive, antibiotic therapy was initiated on the presumption of a mycotic abdominal aneurysm. Six days after admisslon, he complained of numbness in the lower extremities and both femoral pulsations were not palpable.
Emergency surgery was undertaken. The aneurysm was adhered to the IVC and the ileum and there was a large thrombotic mass in it. Aneurysmectomy and Y-graft interposition were done uneventfully. Pathology revealed marked thickness of the aorta and infiltration of lots of imflammatory cells. The culture of aneurysmal wall was negative. This is the very rare case because of sudden thrombotic occlusion of the mycotic abdominal aneurysm. Several important features of this disease have been also discussed.
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