Department of Vascular and Endovascular Surgery, Command Hospital (Southern Command), Pune, Maharashtra, India
Department of Vascular and Endovascular Surgery, Army Hospital (Research and Referral), New Delhi, New Delhi, India.
BMJ Case Rep. 2022 Nov 2;15(11):e251838. doi: 10.1136/bcr-2022-251838.
A gentleman in his late 30s presented with a history of evening rise of temperature and generalised malaise of 1-week duration. He had associated upper back pain with tingling and numbness of both lower limbs. An unexplained episode of hypotension with hemoptysis propelled a computed tomography (CT) examination of chest which was suggestive of a pseudoaneurysm of the posterior wall of descending thoracic aorta in the vicinity of the Pott's spine with a prevertebral and paravertebral abscess, for which he was referred to vascular surgeons.Tubercular involvement of vasculature is a rare disease, aortic involvement even rarer. Less than 50 cases of vertebral tuberculosis with tubercular thoracic aortic aneurysm have been reported in the medical literature, but the disease carries a colossal mortality and morbidity.After a multidisciplinary teamwork, thoracic endovascular aortic repair was done for exclusion of the aneurysmal segment, with simultaneous antitubercular and broad-spectrum antibiotic chemotherapy. The patient recuperated well.
一位 30 多岁的绅士,有发热和全身不适的病史,持续 1 周。他伴有上背部疼痛,伴有双下肢刺痛和麻木。一次不明原因的低血压伴有咯血,促使进行胸部 CT 检查,提示降主动脉后壁假性动脉瘤位于 Pott 脊柱附近,伴有椎体前和椎旁脓肿,因此他被转介给血管外科医生。血管结核受累是一种罕见的疾病,主动脉受累更为罕见。在医学文献中,只有不到 50 例报告了脊柱结核伴胸主动脉假性动脉瘤,但该疾病死亡率和发病率都很高。经过多学科团队合作,进行了胸主动脉腔内修复术,以排除动脉瘤段,同时进行抗结核和广谱抗生素化疗。患者恢复良好。