Vy Tran Thanh, Bang Ho Tat, Doan Ngoc Tuan Pham, Thuy Tran Thi Mai, Vu Phan Ton Ngoc, Cuong Lam Thao
Thoracic and Vascular Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
SAGE Open Med Case Rep. 2024 Aug 22;12:2050313X241271883. doi: 10.1177/2050313X241271883. eCollection 2024.
Infective native abdominal aortic aneurysms are a life-threatening condition with a high mortality rate. We report the case of a 53-year-old male patient who presented with abdominal pain and fever. Laboratory results showed an elevated white blood cell count and C-reactive protein levels. Blood cultures detected species, and computed tomography revealed a saccular abdominal aortic aneurysm. After 14 days of preoperative antibiotic therapy, the patient underwent a successful surgical bypass from the descending thoracic aorta, through the diaphragm and muscle layers of the anterior abdominal wall, to the bilateral common femoral arteries. The patient was discharged after 30 days of hospitalization and continued antibiotic treatment for another 30 days. Follow-up clinical evaluations and imaging studies showed good recovery and no signs of infection. This case highlights the importance of combining appropriate antibiotic therapy with surgical intervention in managing infective native aortic aneurysms. In particular, an extra-anatomical approach from the descending aorta can be a viable option in selected cases of infected aortic aneurysms, providing an effective means to achieve thorough debridement and prevent future graft infections.
感染性原发性腹主动脉瘤是一种危及生命的疾病,死亡率很高。我们报告一例53岁男性患者,其表现为腹痛和发热。实验室检查结果显示白细胞计数和C反应蛋白水平升高。血培养检测到菌种,计算机断层扫描显示为囊状腹主动脉瘤。经过14天的术前抗生素治疗后,患者成功接受了从降主动脉经膈肌和前腹壁肌肉层至双侧股总动脉的手术搭桥。患者住院30天后出院,并继续接受30天的抗生素治疗。随访临床评估和影像学检查显示恢复良好,无感染迹象。该病例强调了在处理感染性原发性主动脉瘤时,将适当的抗生素治疗与手术干预相结合的重要性。特别是,在某些感染性主动脉瘤病例中,从降主动脉采用解剖外途径可能是一种可行的选择,为实现彻底清创和预防未来移植物感染提供了一种有效手段。