Successful Treatment for a Ruptured Solitary Tuberculous Aneurysm of the Left External Iliac Artery: A Case Report

• Published in: Japanese Journal of Vascular Surgery Vol. 32; no. 4; pp. 257 - 260
• Main Authors: Yoshida, Homare, Shimoe, Yasushi, Hosoya, Yuta, Okuda, Naoki, Kawahito, Tomohisa
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR VASCULAR SURGERY 02.07.2023
• Subjects: external iliac artery aneurysm; extra-anatomical revascularization; ruptured aneurysm; tuberculous aneurysm
• ISSN: 0918-6778; 1881-767X
• DOI: 10.11401/jsvs.23-00026

We report an extremely rare case of ruptured tuberculous external iliac artery aneurysm. A 75-year-old woman was admitted to another hospital 8 months ago for pleural inflammation and was treated with antibiotics. Mycobacterium tuberculosis was detected in the pleural fluid submitted at that time. She had been suspected of having an iliopsoas abscess by her local doctor due to left lower abdominal pain and fever for 2 weeks, and was treated with antibiotics, but the symptoms did not improve. A contrast-enhanced CT scan was performed, and a diagnosis of ruptured infected left external iliac artery aneurysm was made. Emergency laparotomy was performed, and the patient underwent aneurysmectomy, drainage, and extra-anatomical bypass with rifampicin-immersed Dacron graft. Tubercle bacilli were detected locally, and histopathological examination revealed specific tuberculous lesions on the aneurysmal wall, leading to the diagnosis of tuberculous aneurysm. The patient was discharged from the hospital on the 68th postoperative day after with anti-tuberculosis drugs. The patient continued chemotherapy for one year after surgery, and no recurrence has occurred for more than five years after an end of chemotherapy.