title: Mycotic abdominal aortic pseudoaneurysm caused by a penetrating atherosclerotic ulcer: report of a case.
abstract: We report a case of mycotic abdominal aortic pseudoaneurysm caused by a penetrating atherosclerotic ulcer (PAU). An 81-year-old woman was admitted to a local hospital with fever and abdominal pain, and when her symptoms were not improved by antibiotics, she was referred to our department. Computed tomography (CT) and angiography showed a saccular aneurysm below the renal arteries, and an emergency laparotomy was performed because we suspected a mycotic abdominal aortic pseudoaneurysm. An abscess was found on the proximal side of the jejunum, caused by an aneurysm penetrating the serosa. We diagnosed a mycotic pseudoaneurysm after finding the anterior wall of the aorta penetrated by intense calcification. The pseudoaneurysm was resected with the abscess and the area was covered with a pedicled omental flap to prevent infection. An axillofemoral bypass was also done. The patient recovered well.
authors.affiliation: Second Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago 683-8504, Japan.
authors.forename: Munehiro
authors.initials: M
authors.lastname: Saiki
authors.forename: Kengo
authors.initials: K
authors.lastname: Nishimura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ikebuchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Hiroe
authors.forename: Maromi
authors.initials: M
authors.lastname: Tachibana
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kanaoka
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Ohgi
mesh_terms: D018784:Abdominal Abscess / Q000150:complications*; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology* / Q000382:microbiology*; D000785:Aneurysm, Infected / Q000209:etiology* / Q000473:pathology; D000792:Angiography; D001012:Aorta, Abdominal / Q000473:pathology*; D001161:Arteriosclerosis / Q000150:complications*; D005260:Female; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications*; D014057:Tomography, X-Ray Computed; D014456:Ulcer / Q000150:complications*