Kwon Tae-Won, Shin Eui-Sup, Kim Do-kyun, Lee Sang-Oh, Kim Geun-Eun
Division of Vascular Surgery, Department of Surgery, University of Ulsan College of Medicine and Asian Medical Center, Seoul, Korea.
Ann Vasc Surg. 2003 Jul;17(4):464-7. doi: 10.1007/s10016-003-0015-0.
Ruptured aortic aneurysms due to Salmonella not of typhi species are rare and associated with high morbidity and mortality. We present three patients with Salmonella-infected ruptured aortic aneurysms successfully treated with an in situ prosthetic bypass graft. One patient had a saccular aneurysm at the infrarenal aorta and two patients had fusiform aneurysms at the aortic bifurcation. All the patients were treated with wide debridement of the infected aortic tissue followed by in situ graft replacement and long-term systemic antibiotic therapy. The method of revascularization, in situ bypass or extraanatomic bypass, remains controversial. On the basis of our clinical experience and recent literature focusing on more than 10 cases, in situ bypass reconstruction may be a feasible surgical technique for Salmonella-infected ruptured aortic aneurysm.
非伤寒沙门氏菌引起的主动脉瘤破裂罕见,且发病率和死亡率高。我们报告了3例沙门氏菌感染所致主动脉瘤破裂患者,经原位人工血管旁路移植术成功治疗。1例患者为肾下腹主动脉囊状动脉瘤,2例患者为主动脉分叉处梭形动脉瘤。所有患者均接受了感染主动脉组织的广泛清创,随后进行原位血管移植置换及长期全身抗生素治疗。血运重建方法,即原位旁路或解剖外旁路,仍存在争议。基于我们的临床经验及近期针对10余例病例的文献,原位旁路重建可能是治疗沙门氏菌感染所致主动脉瘤破裂的一种可行手术技术。