[Mycotic aneurysms--A retrospective analysis].
12 patients (10 males and 2 females, average age 53 years) were operated upon in our hospital between 1994 and 1999 for mycotic aneurysms. The aneurysms were located in 7 patients in the aorto-iliac segment, 5 patients were treated for peripheral or visceral aneurysms. Two of these patients suffered from multiple aneurysms. When peripheral arteries were affected, a pulsatile tumour was felt. Most of these tumours developed in a relatively short period of time and sometimes a perivascular inflammation occurred. This was not the case when central arteries were attacked. A septic process or an infection, for example salmonella-enteritis, often preceded shortly the development of a mycotic aneurysm. In the case of an aneurysm of the aorto-iliac section we consider an in situ reconstruction with alloplastic material in combination with a perivascular debridement, lavage and omentum majus plastic as the treatment of choice. In peripheral arteries reconstruction should be performed with autologous vessels. Depending on the local findings, a perivascular debridement should also be performed in these cases. The reconstruction always should be combined with a calculated antibiotic therapy. Two of our patients died perioperatively. During follow up, 8 patients showed patent reconstructions and no signs of infection. The urgency of surgery depends on the level of inflammation and the existence of any secondary complications.
Klein
F
F
Klinik für Allgemein, Gefäss und Thoraxchirurgie, Klinikum Neubrandenburg, Germany.
Drews
J
J
Bürger
K
K
Lange
H
H
Ernst
M
M
D000328:Adult; D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D001027:Aortography; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed