Iijima Makoto, Azuma Ryota, Hieda Tetsuya, Makino Yutaka
Department of Cardiovascular Surgery, Oji General Hospital, Tomakomai, Hokkaido, Japan.
J Surg Case Rep. 2018 Feb 20;2018(2):rjy020. doi: 10.1093/jscr/rjy020. eCollection 2018 Feb.
We describe the surgical management of a 58-year-old man with inflammatory abdominal aortic aneurysm (IAAA) following treatment with preoperative steroids. The patient was transferred to our institution for abdominal pain and fever. Contrast-enhanced computed tomography showed juxtarenal abdominal aortic aneurysm surrounded by dense perianeurysmal fibrous tissue. Under a diagnosis of IAAA, steroid therapy with prednisolone was initiated to control the perianeurysmal inflammation. It continued for 3 weeks with a decreasing dose schedule, with remarkable decrease in the soft tissue mass. The patient underwent elective surgery 21 days after commencing steroid therapy. During surgery, adjacent organs were adherent to the aneurysmal wall, but fibrotic change to the retroperitoneum was very limited. He recovered uneventfully, and was discharged on postoperative Day 10. Therefore, it can be concluded that preoperative steroid therapy could minimize the operative risk for IAAAs, and improve surgical outcome.
我们描述了一名58岁患有炎性腹主动脉瘤（IAAA）的男性患者在术前使用类固醇治疗后的手术管理情况。该患者因腹痛和发热被转至我院。增强计算机断层扫描显示肾旁腹主动脉瘤被致密的瘤周纤维组织包围。在诊断为IAAA后，开始使用泼尼松龙进行类固醇治疗以控制瘤周炎症。治疗持续3周，剂量逐渐减少，软组织肿块明显缩小。患者在开始类固醇治疗21天后接受了择期手术。手术过程中，相邻器官与动脉瘤壁粘连，但腹膜后的纤维化改变非常有限。他恢复顺利，术后第10天出院。因此，可以得出结论，术前类固醇治疗可将IAAA的手术风险降至最低，并改善手术效果。
