Al-Ani Haya Husam, Khashram Manar, Dean Anastasia, Bourchier Russell, Bhamidipaty Venu, Hill Andrew
Department of Vascular Surgery, Auckland City Hospital, Auckland, New Zealand.
Department of Vascular Surgery, Auckland City Hospital, Auckland, New Zealand.
Ann Vasc Surg. 2019 Nov;61:469.e1-469.e4. doi: 10.1016/j.avsg.2019.05.021. Epub 2019 Aug 2.
Primary infected abdominal aortic aneurysm (AAA) is an uncommon presentation which can be associated with significant morbidity and mortality. In this report, we present 2 cases of infected AAAs less than 10 days after a transrectal ultrasound-guided (TRUS) prostate biopsy. A 63-year-old male presenting with sepsis and back pain 9 days after TRUS biopsy was found to have a 27-mm ectatic abdominal aorta which expanded to 59 mm in the course of a week, despite antibiotic therapy. He underwent successful surgical excision of the infected aortic aneurysm and reconstruction using a vein. A 55-year-old male presented similarly, 7 days after prostate biopsy with a 60-mm aortic aneurysm. His aneurysm ruptured 2 days before planned intervention-he did not survive an emergency repair. In both cases, aortic tissue biopsies confirmed growth of Escherichia coli. Preexistence of an aortic aneurysm was not known in either case as neither patient had imaging of the abdominal aorta. We postulate the pathophysiology was due to hematogenous spread.
原发性感染性腹主动脉瘤（AAA）是一种不常见的表现，可伴有显著的发病率和死亡率。在本报告中，我们呈现了2例经直肠超声引导（TRUS）前列腺活检后不到10天的感染性AAA病例。一名63岁男性在TRUS活检后9天出现败血症和背痛，发现有一个27毫米的扩张性腹主动脉，尽管进行了抗生素治疗，但在一周内扩大到了59毫米。他接受了感染性主动脉瘤的成功手术切除，并使用静脉进行了重建。一名55岁男性情况类似，前列腺活检后7天发现有一个60毫米的主动脉瘤。他的动脉瘤在计划干预前2天破裂，紧急修复未能成功存活。在这两个病例中，主动脉组织活检均证实大肠杆菌生长。由于两名患者均未对腹主动脉进行成像，因此在这两个病例中之前是否存在主动脉瘤均未知。我们推测其病理生理机制是血行播散。
