Two Cases of Infected Aortic Abdominal Aneurysm with Spondylodiskitis

We encountered two cases of infected aortic abdominal aneurysm with spondylodiskitis. Both cases were diagnosed on the basis of fever, back pain and pulsatile abdominal mass. A 69-year-old man, case 1, underwent in situ reconstruction 1 year from the onset, because the infection was controllable by...

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Published inJapanese Journal of Cardiovascular Surgery Vol. 28; no. 2; pp. 121 - 124
Main Authors Tohyama, Satoshi, Koyanagi, Hitoshi, Maeda, Tomohiro, Tsukui, Hiroyuki, Aomi, Shigeyuki, Kunii, Yoshifumi, Nishinaka, Tomohiro
Format Journal Article
LanguageJapanese
Published The Japanese Society for Cardiovascular Surgery 1999
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ISSN0285-1474
1883-4108
DOI10.4326/jjcvs.28.121

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Abstract We encountered two cases of infected aortic abdominal aneurysm with spondylodiskitis. Both cases were diagnosed on the basis of fever, back pain and pulsatile abdominal mass. A 69-year-old man, case 1, underwent in situ reconstruction 1 year from the onset, because the infection was controllable by antibiotics and he had diabetes mellitus. A 68-year-old man, case 2, underwent operation while his infection was still active, because of paralysis of the bilateral lower extremities, aggravated by invasion of the vertebrae by the abscess. To prevent artificial graft infection, he underwent axillo-femoral bypass, which was extra-anatomical reconstruction, after the infected aneurysm and vertebrae were removed during aortic clamping above the aneurysm and bilateral common iliac arteries. Each stump was sutured and anterior fixation of the vertebrae was performed using an iliac bone graft. The postoperative course of both patients was successful. These cases suggest that the timing and procedure of the operation for infected aortic abdominal aneurysm with spondylodiskitis should be decided depending on the activity of infection, complications, age and activity of daily life of patients.
AbstractList We encountered two cases of infected aortic abdominal aneurysm with spondylodiskitis. Both cases were diagnosed on the basis of fever, back pain and pulsatile abdominal mass. A 69-year-old man, case 1, underwent in situ reconstruction 1 year from the onset, because the infection was controllable by antibiotics and he had diabetes mellitus. A 68-year-old man, case 2, underwent operation while his infection was still active, because of paralysis of the bilateral lower extremities, aggravated by invasion of the vertebrae by the abscess. To prevent artificial graft infection, he underwent axillo-femoral bypass, which was extra-anatomical reconstruction, after the infected aneurysm and vertebrae were removed during aortic clamping above the aneurysm and bilateral common iliac arteries. Each stump was sutured and anterior fixation of the vertebrae was performed using an iliac bone graft. The postoperative course of both patients was successful. These cases suggest that the timing and procedure of the operation for infected aortic abdominal aneurysm with spondylodiskitis should be decided depending on the activity of infection, complications, age and activity of daily life of patients.
Author Kunii, Yoshifumi
Tohyama, Satoshi
Nishinaka, Tomohiro
Aomi, Shigeyuki
Maeda, Tomohiro
Tsukui, Hiroyuki
Koyanagi, Hitoshi
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  organization: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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  fullname: Koyanagi, Hitoshi
  organization: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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  fullname: Maeda, Tomohiro
  organization: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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  fullname: Tsukui, Hiroyuki
  organization: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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  fullname: Aomi, Shigeyuki
  organization: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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  fullname: Kunii, Yoshifumi
  organization: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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  fullname: Nishinaka, Tomohiro
  organization: Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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References 4) Pasic, M., Carrel, T., Tonz, M. et al.: Mycotic aneurysm of the abdominal aorta: extraanatomic versus in situ reconstruction. Cardiovasc. Surg. 1: 48-52, 1993.
3) Chiba, Y., Muraoka, R., Ihaya, T. et al.: Surgical treatment of infected thoracic and abdominal aortic aneurysms. Cardiovasc. Surg. 4: 476-479, 1996.
5) 千葉幸夫, 村岡隆介, 井隼彰夫ほか: 細菌性感染性動脈瘤の外科治療. 日心外会誌22: 409-413, 1993.
8) 笠井裕一, 西村英也, 山川徹ほか: 化膿性脊椎炎による仮性大動脈瘤の1例. 整・災外31: 1703-1707, 1988.
1) Chan, F. Y., Crawford, E. S., Coselli, J. S. et al.: in situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann. Thorac. Surg. 47: 193-203, 1989.
2) Taylor, L. M., Deitz, D. M., McConnell, D. B. et al.: Treatment of infected abdominal aneurysms by extraanatomic bypass, aneurysm excision, and drainage. Am. J. Surg. 155: 655-658, 1988.
6) Robinson, J. A. and Johansen, K.: Aortic sepsis: Is there a role for in situ graft reconstruction? J. Vasc. Surg. 13: 677-684, 1991.
7) 菊地廣行, 前山俊秀, 佐藤孝臣ほか: 腸腰筋膿瘍に続発した感染性動脈瘤の1例. 臨外45: 1811-1813, 1990.
References_xml – reference: 5) 千葉幸夫, 村岡隆介, 井隼彰夫ほか: 細菌性感染性動脈瘤の外科治療. 日心外会誌22: 409-413, 1993.
– reference: 6) Robinson, J. A. and Johansen, K.: Aortic sepsis: Is there a role for in situ graft reconstruction? J. Vasc. Surg. 13: 677-684, 1991.
– reference: 1) Chan, F. Y., Crawford, E. S., Coselli, J. S. et al.: in situ prosthetic graft replacement for mycotic aneurysm of the aorta. Ann. Thorac. Surg. 47: 193-203, 1989.
– reference: 2) Taylor, L. M., Deitz, D. M., McConnell, D. B. et al.: Treatment of infected abdominal aneurysms by extraanatomic bypass, aneurysm excision, and drainage. Am. J. Surg. 155: 655-658, 1988.
– reference: 4) Pasic, M., Carrel, T., Tonz, M. et al.: Mycotic aneurysm of the abdominal aorta: extraanatomic versus in situ reconstruction. Cardiovasc. Surg. 1: 48-52, 1993.
– reference: 8) 笠井裕一, 西村英也, 山川徹ほか: 化膿性脊椎炎による仮性大動脈瘤の1例. 整・災外31: 1703-1707, 1988.
– reference: 3) Chiba, Y., Muraoka, R., Ihaya, T. et al.: Surgical treatment of infected thoracic and abdominal aortic aneurysms. Cardiovasc. Surg. 4: 476-479, 1996.
– reference: 7) 菊地廣行, 前山俊秀, 佐藤孝臣ほか: 腸腰筋膿瘍に続発した感染性動脈瘤の1例. 臨外45: 1811-1813, 1990.
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Snippet We encountered two cases of infected aortic abdominal aneurysm with spondylodiskitis. Both cases were diagnosed on the basis of fever, back pain and pulsatile...
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StartPage 121
SubjectTerms extra-anatomical reconstruction
in situ reconstruction
Title Two Cases of Infected Aortic Abdominal Aneurysm with Spondylodiskitis
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Volume 28
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