title: [Aneurysmal rupture complicating aortitis: a case report].
abstract: Tropical aortitis is a rare and poorly described aortic disease, sometimes confounded with Takayasu's disease, mainly in people from Africa. In this case report, the panaortic aneurysmal disease in a young woman from Haiti, first diagnosed after a work-up on renovascular hypertension, would appear to approach this particular arterial disease with no clinical, radiological or biological argument for an infectious etiology. The initially suspected diagnosis of Takayasu's disease had to be rethought because of the presence of several saccular aneurysms extending from the aortic arch to the infrarenal aorta, rarely described in Takayasu's aortitis. Expert opinions from vascular surgeons and clinicians tagged this aortic disease as similar to tropical aortitis which remained asymptomatic for more than a decade. Hypertension was managed with successful balloon angioplasty of the left renal artery stenosis and anti-hypertensive combination therapy. Surgical management of the extended aortic aneurysms was not proposed because of the stability and asymptomatic nature of the aneurysmal disease and the high risk of surgical morbidity and mortality. More than ten years after diagnosis, the course was marked with inaugural and sudden-onset chest pain concomitant with contained rupture of the descending thoracic aortic aneurysm. This case report underlines the persistent risk of aneurysmal rupture and the importance of an anatomopathological study for the diagnosis of complex aortic disease.
authors.affiliation: Unité HTA, centre de diagnostic et de thérapeutique, prévention et thérapeutique cardiovasculaires, faculté de médecine, université Paris-Descartes, hôpital Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Yannoutsos
authors.affiliation: Département de chirurgie thoracique, vasculaire et transplantation cardio-pulmonaire, hôpital Marie-Lannelongue, 92350 Le Plessis-Robinson, France.
authors.forename: O
authors.initials: O
authors.lastname: Mercier
authors.affiliation: Pôle cardiovasculaire, service de médecine vasculaire-HTA, hôpital européen G.-Pompidou, 75908 Paris cedex 15, France.
authors.forename: E
authors.initials: E
authors.lastname: Messas
authors.affiliation: Unité HTA, centre de diagnostic et de thérapeutique, prévention et thérapeutique cardiovasculaires, faculté de médecine, université Paris-Descartes, hôpital Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, place du Parvis-Notre-Dame, 75004 Paris, France.
authors.forename: M E
authors.initials: ME
authors.lastname: Safar
authors.affiliation: Unité HTA, centre de diagnostic et de thérapeutique, prévention et thérapeutique cardiovasculaires, faculté de médecine, université Paris-Descartes, hôpital Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, place du Parvis-Notre-Dame, 75004 Paris, France. Electronic address: jacques.blacher@htd.aphp.fr.
authors.forename: J
authors.initials: J
authors.lastname: Blacher
mesh_terms: D017542:Aneurysm, Ruptured / Q000209:etiology* / Q000601:surgery; D000800:Angioplasty, Balloon; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology* / Q000601:surgery; D001025:Aortitis / Q000150:complications* / Q000175:diagnosis; D001027:Aortography; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006205:Haiti / Q000208:ethnology; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy; D012422:Rupture, Spontaneous; D013625:Takayasu Arteritis / Q000175:diagnosis
chemical_list: D000959:Antihypertensive Agents
keywords: Aneurysmal rupture; Aortite tropicale; Endovascular and surgical aortic repair; Maladie de Takayasu; Rupture anévrismale; Takayasu's disease; Traitement chirurgical aortique; Traitement endovasculaire; Tropical aortitis