感染性腹部大動脈瘤の１例―最近１０年間の本邦報告例の検討―

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  • A CASE OF INFECTED ABDOMINAL AORTIC ANEURYSM

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A 60-year-old male with abdominal pain was transferred to our hospital. Physical examination showed right lower abdominal tenderness. He was admitted with a suspicious diagnosis of acute appendicitis. Antibiotic therapy resulted in no improvement in clinical symptoms and an inflammatory response on the fifth hospital day. Abdominal CT showed enlargement of an abdominal aorta below the renal arteries, and this area protruded anteriorly to form a succular aneurysm. Impending repture of infected abdominal aortic aneurysm (IAAA) was diagnosed, and an emergency operation was performed. After an extra-anatomic bypass was constructed, we resected the IAAA. The intima of the arterial wall was disrupted. The blood and aortic wall cultures were negative. The patient's postoperative course was uneventful, and he has been doing well with no recurrence of infection. IAAA is a relatively rare disease, 38 cases have been reported in 10 years in the Japanese literature. The timing and operative procedure are controversial. We presented the case here together with a review of the literature.

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