Mycotic abdominal aortic aneurysm: a case report

A case of mycotic aneurysm of the abdominal aorta, arising as a complication of subacute bacterial endocarditis in a 75-year-old white woman, is presented. The dramatically expansile nature of this aneurysm is well documented. The history, clinical presentation, etiology, microbiology and surgical management of this rapidly progressive and often fatal condition are discussed through a review of the literature.     

Congenital abdominal aortic aneurysm: a case report

Abdominal aortic aneurysm (AAA) is distinctly uncommon in infants and children, and usually results from infection, iatrogenic trauma, vasculitis, connective tissue disorder, or tuberous sclerosis. Congenital "primary" neonatal AAA is exceedingly rare. The few reported cases of repair of congenital AAA describe use of synthetic graft material or aneurysmorrhaphy. We report the first successful treatment of a known 6 cm congenital infrarenal AAA repaired with a 5 mm cryopreserved allograft in a 4-month-old infant girl. The graft was pretreated with an antigen reduction process (SynerGraft), which preliminary studies suggest may inhibit allograft degeneration. The postoperative course was unremarkable. Lower extremity pulses and results of duplex ultrasound flow studies remained excellent at 14-month follow-up. Panel reactive antibodies against class I alloantigens remain negative. The use of an antigen-reduced allograft provides an acceptable conduit, which potentially may decrease allograft degeneration and relative graft stenosis associated with growth of the child, but requires follow-up.     

Chiropractic management of abdominal aortic aneurysm: a case report

Aortic dilatation is a common and potentially life-threatening condition with which a patient may present to the chiropractor. It is most often detected in males over 50, particularly in association with hypertensive disease. This case illustrates the classic clinical and radiologic features of a large (13cms) abdominal aortic aneurysm. The manipulative management of patients with abdominal aortic aneurysm is discussed.     

Pituitary apoplexy after aortic abdominal aneurysm surgery: a case report

Pituitary apoplexy (PA) occurring after surgery is a rare but life-threatening acute clinical situation following extensive haemorrhage or necrosis within a pituitary adenoma. Pituitary apoplexy has been reported to occur spontaneously in the majority of cases or in association with various inducing factors. One of the pathophysiological mechanism that has been postulated is the fall of arterial blood pressure inducing ischaemia followed by infarction of the pituitary gland. We report a case of pituitary apoplexy following aortic abdominal surgery. To our knowledge, this has not been previously reported. A 73-year old man complained of headache and diplopia. At clinical examination, he presented a right oculomotor nerve palsy. Magnetic resonance imaging (MRI) showed a haemorrhagic sellar mass. In our case, intraoperative hypotension could have been the precipitating factor. Diagnostic and therapeutic measures are discussed.     

Stent graft infection after abdominal aortic aneurysm repair: a case report

A 77-year-old man had clinical and radiologic signs of graft infection develop 1 year after stent grafting for abdominal aortic aneurysm. Blood cultures grew Bacteroides fragilis, and cultures of the aneurysm sac grew Enterococcus. The patient's condition was successfully managed with staged extraanatomic revascularization followed by graft excision. Although stent graft infection to date is extremely rare, some aspects peculiar to the placement of these devices potentially could increase their susceptibility to infection. Recognition and standard techniques in management can lead to successful outcome.     

Gluteal compartment syndrome following abdominal aortic aneurysm repair: a case report

Compartment syndromes occur when the elevated tissue pressure within a confined limb's myofascial compartment exceeds capillary pressure, with subsequent neurovascular compromise. In order to reduce disability and the consequences of ensuring ischemia, it is essential for early recognition and intervention. This is more commonly recognized in the calf. We report an unusual case of gluteal compartment syndrome after abdominal aortic aneurysm (AAA) repair.     

Infected abdominal aortic aneurysm caused by Brucella abortus: a case report

This case report describes an infected aneurysm caused by Brucella abortus. To the best of our knowledge, this case represents the first reported occurrence of an infected abdominal aortic aneurysm caused by this pathogen. The clinical findings included mild fever, fatigue, cold sweats, and abdominal pain. The diagnosis was reached by computed tomography scanning. The patient was treated by urgent surgery, which consisted of resection of the aneurysmal sac, prosthetic graft replacement, and omental wrapping. Antibiotics were administrated for 3 months. A bacteriologic specimen was isolated from the blood culture. At 1 year 10 months after surgery, the patient remains in good health.     

Ross procedure with aortic replacement for aortic stenosis with ascending aortic aneurysm: report of a case

Bicuspid aortic valve (BAV) is a common congenital heart disease, and it is well known to be a risk factor for ascending aortic dilatation and dissection. We here report a case of 34-year-old woman who underwent Ross procedure with ascending aortic replacement under the diagnosis of subaortic stenosis and ascending aortic aneurysm. She was pointed out to have heart murmur soon after the birth diagnosed as patent ductus arteriosus. The ductus was ligated when she was 3-years-old, however, heart murmur remained. Further examinations revealed that she also had aortic stenosis with BAV. During her 20-year-follow-up, subaortic stenosis and ascending aorta ectasia were also progressed. Pathological examinations of resected ascending aortic wall showed mucoid degeneration and laceration of collagen fibers, suggesting the fragility of dilated aortic wall with BAV.     

Combining open and endovascular surgery for the treatment of infrarenal abdominal aortic aneurysm: a case report using a hybrid vascular graft

Migration and endoleaks after endovascular exclusion of an infrarenal abdominal aortic aneurysm may lead to long-term failure of the stent graft. We report a successful case of a novel technique that combined open and endovascular surgery to address the issues of migration and endoleak in the repair of an abdominal aortic aneurysm. The hybrid graft, consisting of a proximal, conventional Dacron graft and two distal endoprosthesis limbs, was designed to reduce aortic cross-clamp time in aortic procedures. This is the first reported clinical experience with this new hybrid vascular graft for the treatment of an abdominal aortic aneurysm.     

Horseshoe kidney and inflammatory abdominal aortic aneurysm: a case report and literature review

The combined presence of an inflammatory abdominal aortic aneurysm and a horseshoe kidney is a rare event with only one reported case in previously published data. We present a case of a horseshoe kidney with a concomitant 6-cm inflammatory abdominal aortic aneurysm and a 3.6-cm right iliac artery aneurysm repaired through a transperitoneal approach with aortoiliac reconstruction.     

Surgical treatment of syphilitic ascending aortic aneurysm: a case report

A 67-year-old man with positive serum reaction for syphilis had been followed by cardiologist for his moderate-sized saccular ascending aortic aneurysm and small-sized abdominal aortic aneurysm. Because of his transient ischemic attack probably secondary to the thrombo-embolism of the aneurysm and rapid growing of its size, surgical treatment was recommended. Resection of the saccular aneurysm with patch plasty of the ascending aorta was performed under the cardiopulmonary bypass associated with right side cerebral perfusion. At the time of operation, the mildly dilated ascending aorta and arch with multiple intimal ulceration were noted. Although his postoperative hemodynamic condition was stable, he suffered from multiple cerebral infarction, probably due to embolism migrated from the fragile aortic intima. His neurological condition was improved promptly, trivial hemi-paralysis was remained. The specimen of resected aneurysmal wall revealed syphilitic changes microscopically. We concluded that the extent of the aortic replacement with prosthetic graft should be deceived not only with its external appearance, but also with the changes of its inside.     

Surgical treatment of abdominal aortic aneurysm associated with horseshoe kidney and coagulopathy case report

The coexistence of horseshoe kidney and aortic aneurysm poses a technical challenge to the vascular surgeon during aneurysm repair. Whether to divide the renal isthmus and how to approach the aneurysm are still matters of controversy, and coagulopathy sometimes occurs in patients with nontreated abdominal aortic aneurysm (AAA). We describe the successful surgical repair of an AAA with horseshoe kidney via the transperitoneal approach and division of the renal isthmus by harmonic scalpel. Exclusion of a thrombosed aneurysm can ameliorate coagulopathy due to AAA.     

Inflammatory abdominal aortic aneurysm treated by endovascular stent grafting: a case report

Despite complications inherent to open surgical repair of inflammatory abdominal aortic aneurysms, there is expected resolution of the retroperitoneal inflammatory process following graft replacement. An endovascular approach could also exclude the aneurysm while potentially avoiding injury to vital structures in the hostile operative field. However, data are limited regarding the role of endovascular stent grafts in the management of inflammatory abdominal aortic aneurysms. Furthermore, postoperative regression of perianeurysmal inflammation is rarely discussed in the few published accounts of endovascular repair of inflammatory aortic aneurysms. The case presented demonstrates successful endovascular treatment of an infrarenal inflammatory aneurysm with resolution of the retroperitoneal inflammation and hydronephrosis.     

Management of an abdominal aortic aneurysm infected with Campylobacter fetus: a case report

We present a rare case of an abdominal aortic aneurysm (AAA) infected with Campylobacter fetus. The patient presented with abdominal pain and leukocytosis, without a palpable AAA. Computed tomography (CT) of the abdomen showed a 3.1 x 3.0 cm infrarenal abdominal aneurysm with an extra-aortic fluid collection. At surgery, an in situ graft was placed. Intraoperative aortic wall cultures grew pansensitive C. fetus, and blood cultures remained negative. At 9-month follow-up, the patient was doing well without complaints. To our knowledge, this represents only the ninth reported case of an AAA with an aortic wall culture positive for C. fetus.     

Modular component separation and reperfusion of abdominal aortic aneurysm sac after endovascular repair of the abdominal aortic aneurysm: A case report

Transluminal placement of a stent graft in patients with an abdominal aortic aneurysm is a new endovascular technique that offers a potentially less invasive and less risky alternative to open surgery. Complications after stent graft placement are not infrequent, but in most cases secondary endovascular intervention is successful. We describe a late major leak in the aneurysmal sac caused by a distal migration of the iliac limb of a bifurcated graft. This late complication was successfully treated by covered stent placement, excluding and thrombosing completely the reformed aneurysm. (J Vasc Surg 1998;28:349-352)     

Acute thrombosis of abdominal aortic aneurysm subsequent to Heimlich maneuver: a case report

We report a case of acute thrombosis of an abdominal aortic aneurysm secondary to a correctly applied and successful Heimlich maneuver. Although the Heimlich maneuver is generally safe and effective, this possible catastrophic consequence needs to be recognized.     

Renal cell carcinoma in a horseshoe kidney with abdominal aortic aneurysm: a case report

We herein report a case of renal cell carcinoma in a horseshoe kidney with an abdominal aortic aneurysm in a 69-year-old man. Radiological examinations showed a left renal tumor, horseshoe kidney and abdominal aortic aneurysm. We performed a left radical nephrectomy with the division of the isthmus and artificial graft through an abdominal transperitoneal approach. Histological findings revealed clear cell type renal cell carcinoma without invasion of the capsule or renal pelvis. Only 31 cases of renal cell carcinoma in a horseshoe kidney have been reported in Japan, and our case is the 32nd. No case with abdominal aortic aneurysm has been reported previously. We assume that abdominal aortic aneurysm was associated with renal cell carcinoma by chance in the horseshoe kidney in this case. The arterial and venous supplies vary from case to case. We emphasize that arteriography and venography are very important preoperative procedures.     

Ruptured abdominal aortic aneurysm and horseshoe kidney. A case report

A patient with a ruptured abdominal aortic aneurysm associated with a horseshoe kidney is reported on. The treatment included aneurysmectomy and insertion of an aortic Dacron prosthesis without division of the isthmus of the kidney. The postoperative course was complicated by a stroke and mild renal failure, but the patient made excellent progress and was discharged from hospital 1 month after admission.