Okamoto Yuki, Shindo Shunya, Matsumoto Masahiko
Second Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan.
Ann Thorac Cardiovasc Surg. 2011;17(2):190-3. doi: 10.5761/atcs.cr.09.01462.
A 72-year-old man with a history of old myocardial infarction was admitted to our hospital for surgical treatment of a ruptured abdominal aortic aneurysm. His hemodynamics was stable. He had left lumbar pain on moving his left leg and constipation for ten days without abdominal pain and high fever. Elevation of fat density around the aneurysm and ureter involvement were noted on the computed tomography. These characteristic image findings indicated inflammatory aortic aneurysm. During operation, an infrarenal abdominal aortic aneurysm with an 8 cm maximum diameter was noted. This aneurysm was firm and thick and adhered to some organs due to inflammation. An 5 × 5 cm punched-out defect was found on the lateral wall of the aneurysm. We replaced the ruptured aneurysm with a Dacron graft. Histological examination showed that the aneurysm wall had an infiltrate of inflammatory cells, lymphoid follicles and thickened adventitia. From these findings, the diagnosis was inflammatory aortic aneurysm.
一名有陈旧性心肌梗死病史的72岁男性因腹主动脉瘤破裂入院接受手术治疗。他的血流动力学稳定。他左腿活动时左腰部疼痛，便秘10天，无腹痛和高热。计算机断层扫描显示动脉瘤周围脂肪密度升高以及输尿管受累。这些特征性的影像表现提示为炎性主动脉瘤。手术中，发现一个最大直径为8厘米的肾下腹主动脉瘤。这个动脉瘤质地坚硬且增厚，因炎症与一些器官粘连。在动脉瘤侧壁发现一个5×5厘米的穿孔缺损。我们用涤纶补片替换了破裂的动脉瘤。组织学检查显示动脉瘤壁有炎性细胞浸润、淋巴滤泡和增厚的外膜。根据这些发现，诊断为炎性主动脉瘤。
