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Tuberculous Aneurysm of the Supraceliac AortaA Case ReportDivision of Vascular Surgery, London Health Sciences Centre, University of Western Ontario, 375 South St., Suite N380, London, ON, Canada, N6A 4G5 Tom.Forbes{at}lhsc.on.ca
Division of Vascular Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada Significant vascular complications are rare following systemic infections with Mycobacterium tuberculosis (TB). This report describes a 33-year-old man who presented with a short history of abdominal discomfort and febrile episodes with no prior history of infection with TB. Ultrasound, CT scan, and aortography confirmed the presence of a pseudoaneurysm originating from the posterior aspect of the supraceliac aorta at the level of the diaphragm. Via a full thoracoabdominal approach, periaortic inflammatory tissue and the aortic wall itself were debrided, and repair of the pseudoaneurysm was achieved with a synthetic patch. Mycobacterium tuberculosis was isolated from the aortic wall, and anti-TB medications were instituted. Postoperatively the patient did well and was discharged after 14 days. As illustrated by this case, tuberculous mycotic aneurysms of the aorta are optimally treated with a combination of medical and surgical therapy, and early diagnosis is essential to ensure survival.
Vascular and Endovascular Surgery, Vol. 38, No. 1,
93-97 (2004) |
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