真菌性腹主动脉瘤慢性局限性破裂修复术后腰椎持续侵蚀
Continued lumbar spinal erosion after repair of chronic contained rupture of a mycotic abdominal aortic aneurysm.
作者信息
Bhogal Ricky Harminder, Nayeemuddin Mohammed, Akhtar Irfan, Grainger Mel, Downing Richard
机构信息
Department of Vascular Surgery, Worcester Royal Hospital, Worcester, United Kingdom.
出版信息
Surg Infect (Larchmt). 2008 Aug;9(4):475-80. doi: 10.1089/sur.2007.054.
INTRODUCTION
Mycotic aneurysm of the aorta is a rare, dangerous condition. We report a case of an abdominal aortic aneurysm (AAA) caused by Candida albicans.
METHODS
Case report and review of pertinent English-language literature.
CASE REPORT
A 48 year-old man presented with an acute exacerbation of long-standing back pain. Examination revealed a pulsatile epigastric mass, and radiologic examinations confirmed a 9 cm chronic contained rupture of an inflammatory infrarenal AAA. At operation, no posterior aneurysm sac was found, and lumbar vertebral erosion was noted. Lower limb vascularity was secured with left axillo-bifemoral bypass. The patient presented 12 months later with severe non-mechanical back pain. Imaging confirmed continuing vertebral erosion. At laparotomy, an autologous fibula strut was used for spinal stabilization.
CONCLUSION
Aggressive multimodality therapy of infected AAA and associated vertebral osteomyelitis is necessary for a successful outcome.
引言
主动脉霉菌性动脉瘤是一种罕见的危险病症。我们报告一例由白色念珠菌引起的腹主动脉瘤（AAA）病例。
方法
病例报告及相关英文文献综述。
病例报告
一名48岁男性因长期背痛急性加重前来就诊。检查发现上腹部有搏动性肿块，影像学检查证实为一个9厘米的炎性肾下AAA慢性局限性破裂。手术时，未发现后动脉瘤囊，但注意到腰椎椎体侵蚀。通过左腋-双股旁路手术确保了下肢血管供应。12个月后，患者出现严重的非机械性背痛。影像学检查证实椎体侵蚀仍在继续。剖腹手术时，使用自体腓骨支柱进行脊柱稳定。
结论
对于感染性AAA及相关椎体骨髓炎，积极的多模式治疗对于取得成功结果是必要的。
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