title: Rupture of abdominal aortic aneurysm associated with long-term steroid therapy--a case report.
abstract: We report an autopsy case of bronchial asthma patient with a specific abdominal aortic aneurysm. The aneurysm did not show arteriosclerosis, and a specific saccular morphology was noted above the bifurcation. Histologically, necrosis of the media resembling acute aortic dissociation was observed. However, angiitis was ruled out. In addition, the aneurysm showed a cicatrized, old intimal crack in addition to the rupture site, suggesting repeated failures. The long-term steroid therapy-related fragility of the arterial wall may have been involved in the etiology of the aneurysm.
authors.affiliation: Department of Forensic Medicine, Tokyo Medical University, Tokyo 160-8402, Japan; Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo 112-0012, Japan. Electronic address: mizukamh@tokyo-med.ac.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Mizukami
authors.affiliation: Department of Forensic Medicine, Tokyo Medical University, Tokyo 160-8402, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hara
authors.affiliation: Department of Forensic Medicine, Tokyo Medical University, Tokyo 160-8402, Japan.
authors.forename: Masamune
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo 112-0012, Japan; Department of Forensic Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Shirushi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo 112-0012, Japan.
authors.forename: Shinjiro
authors.initials: S
authors.lastname: Mori
authors.affiliation: Department of Forensic Medicine, Tokyo Medical University, Tokyo 160-8402, Japan.
authors.forename: Fumi
authors.initials: F
authors.lastname: Kuriiwa
authors.affiliation: Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo 112-0012, Japan.
authors.forename: Tatsushige
authors.initials: T
authors.lastname: Fukunaga
mesh_terms: D000328:Adult; D017544:Aortic Aneurysm, Abdominal / Q000139:chemically induced* / Q000473:pathology; D001019:Aortic Rupture / Q000473:pathology*; D001249:Asthma / Q000188:drug therapy; D001344:Autopsy; D005260:Female; D006801:Humans; D013256:Steroids / Q000009:adverse effects*
chemical_list: D013256:Steroids
keywords: Acute aortic dissociation; Aortic aneurysm; Long-term steroid therapy; Necrosis of the media; bronchial asthma; medico-legal autopsy