[In situ graft replacement for the thoracoabdominal aortic aneurysm with abscess around the aorta; report of a case].
A 58-year-old woman who complained of epigastralgia, back pain and pyrexia was admitted for further examination. A computed tomography (CT) scan revealed an abnormal mass between the descending aorta and esophagus. Exploratory thoracotomy was performed and brown purulent fluid was drained from the mass. Postoperatively, the white blood cell count normalized and the patient become afebrile. Eleven days postoperatively, circa 500 ml of blood discharged from a chest drain tube. A CT scan demonstrated enlargement of the thoracoabdominal aorta, necessitating an emergency operation. A pseudoaneurysm was found in the thoracoabdominal aorta, with inflammation in the aortic wall. On opening the aneurysmal sac, the intima of the aorta was found to have a partial defect. In situ graft replacement of the thoracoabdominal aorta and reconstruction of the intercostal artery were performed. Finally, a pedicled omental flap was used to cover the artificial graft. Two years postoperatively, the patient is doing well with no recurrence of infection.
Hirai
H
H
Department of Cardiovascular Surgery, Osaka City University School of Medicine, Osaka, Japan.
Suehiro
S
S
Shibata
T
T
Hattori
K
K
Murakami
T
T
Hosono
M
M
Fujii
H
H
Aoyama
T
T
Kinoshita
H
H
D000038:Abscess / Q000150:complications*; D000785:Aneurysm, Infected / Q000150:complications / Q000601:surgery*; D001012:Aorta, Abdominal / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D001018:Aortic Diseases / Q000150:complications*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation; D013524:Surgical Flaps