Tuberculous infection of the descending thoracic and abdominal aorta: case report and literature review.
We report here a case of infrarenal aortic disruption and aortoduodenal fistula secondary to tuberculous aortitis in a 77-year-old man. From a review of experience with operative management of tuberculous infection of the descending thoracic and abdominal aorta reported in the English-language literature, including the current report, we found that operative repair was attempted in 26 patients with tuberculous aortitis of the abdominal (n = 16), thoracic (n = 8), and thoracoabdominal (n = 2) aorta. Six patients had emergent operations for massive hemoptysis (n = 2), aortoduodenal fistula (n = 2), or abdominal rupture (n = 2), with an associated 30-day mortality of 50%. Elective or semi-elective repair was undertaken in 20 patients, of whom 19 (95%) survived for at least 30 days. On the basis of limited experience with this rare entity, in situ graft replacement is an appropriate treatment of tuberculous aneurysms and pseudoaneurysms of the descending thoracic and abdominal aorta.
Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
A D
AD
Allins
W H
WH
Wagner
D V
DV
Cossman
R N
RN
Gold
J R
JR
Hiatt
D000368:Aged; D001012:Aorta, Abdominal; D001013:Aorta, Thoracic; D001025:Aortitis / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D004378:Duodenal Diseases / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D008297:Male; D014381:Tuberculosis, Cardiovascular / Q000453:epidemiology / Q000601:surgery; D016157:Vascular Fistula / Q000209:etiology