Mycotic aneurysm of the suprarenal abdominal aorta.

We report on the successful treatment of a patient with a mycotic aneurysm of the suprarenal aorta. The aorta was resected and reconstructed using an in-situ polytetrafluoroethylene graft with a side arm branch to the left renal artery. The use of polytetrafluoroethylene graft for aortic reconstruction after suprarenal mycotic aneurysm resection has not been previously reported. The etiology, bacteriology, diagnosis, and principles of management of mycotic aneurysms of the suprarenal aorta are discussed.     

Successful surgical treatment of aneurysm of the suprarenal abdominal aorta.

We report the successful surgical resection of a saccular aneurysm of the suprarenal abdominal aorta adjacent to the origin of the superior mesenteric artery. Reconstruction of the superior mesenteric artery with the splenic artery was a useful technique for salvaging the ischemic small intestine. However, successful surgical treatment of this type of aneurysm remains a great challenge.     

Management of suspected mycotic suprarenal aortic aneurysm

Mycotic aortic aneurysm is an uncommonly encountered entity. The diagnosis and management are challenging problems. Involvement of the visceral aorta creates additional problems in management. Experience with a patient having this diagnosis and the dilemma in treatment forms the basis of this report.     

Clostridial mycotic aneurysm of the thoracoabdominal aorta--a case report

Clostridial infection of the aorta is a rare and life-threatening condition. The management of a mycotic aneurysm involving the thoracoabdominal aorta due to Clostridium septicum infection is presented. Successful surgical management of the aortic infection involved arterial resection, wide debridement of the surrounding tissues, and in situ graft replacement. Sixteen additional cases of clostridial infection of the aortoiliac segment reported in the literature are also summarized. In ten of these 17 cases, an associated colonic adenocarcinoma was documented.     

Rapid growth and early rupture of a primary mycotic aneurysm of the abdominal aorta

A case of a primary mycotic aneurysm of the abdominal aorta due to infection with Staphylococcus aureus is presented. The outcome was fatal because of rupture into the jejunum.     

Gunshot wounds of the suprarenal abdominal aorta.

A review of recent series of penetrating aortic injuries is presented. The highest mortality rates were found with injuries of the suprarenal abdominal aorta. Five patients with this injury, four of whom survived, are presented. Factors preventing rapid exsanguination in some patients are explained. Surgical management, including the controversy of arterial debridement, is discussed. The possibility of missing an aortic perforation at operation with five examples from the literature is pointed out.     

Ruptured mycotic aneurysm complicating coarctation of the aorta

A 13-year-old boy with coarctation of the aorta complicated by a staphylococcal mycotic aneurysm is reported. In the course of therapy with antimicrobial agents, rupture into the esophagus with massive hemorrhage necessitated emergency surgical intervention. Review of the literature reveals only 3 other patients who have survived rupture of a mycotic aneurysm associated with coarctation. All were treated with antimicrobial agents plus operation.     

外科手术治疗肾动脉上型腹主动脉瘤

目的 探讨胸腔腹膜后联合入路(TTPI)治疗肾动脉上型腹主动脉瘤(SRAA)的疗效.方法 6例肾动脉上型腹主动脉瘤患者,5例行TTPI手术,1例瘤体破裂者急诊经正中剖腹手术.结果 1例急诊正中开腹手术者术后6小时死于弥散性血管内凝血和多器官功能衰竭:5例采用TTPI术者均存活,但2例术后出现较严重肺部感染;1例出现急性左心功能不全;1例出现急性肾功能不全.无截瘫、脑卒中及消化道出血等并发症发生.平均住院日(16.2±2.5)天,ICU平均住院天数(1.4±0.7)天.结论 对于SRAA,不论破裂与否,术前需通过B超或动脉造影以明确瘤体的范围和分型,通过胸腔腹膜后入路,TTPI能更好的暴露腹主动脉全程,利于控制出血和内脏血管的重建,手术安全性明显提高.     

Hybrid open-endovascular repair of a contained suprarenal mycotic aneurysm using femoral vein

Mycotic aneurysms have a high mortality rate, predominantly driven by sepsis. We present a 61-year-old patient who was treated with a hybrid open-endovascular repair using autologous femoral vein as a single channel revascularization. This provided a practical and innovative approach to a high-risk situation.