[Autologous in situ reconstruction of aortic bifurcation in a patient with ruptured, mycotic abdominal aneurysm--case report].
Primarily infected aortic aneurysms represent a small percentage (0.7-1.31%) of abdominal aortic aneurysms. In this paper, we present a case of a 57-year-old man who was admitted to hospital because of abdominal pain and accompanying fever. Initial diagnosis revealed rupture of aortic bifurcation and the patient was qualified for surgical treatment. Intraopeatively, we encountered ruptured aneurysm of aortic bifurcation, additionally we discovered features of infection (cultures revealed Staphylococcus aureus spp.), which precluded the use of a dacron prostheis. Due to the stable hemodynamic status of the patient, we decided to perform "in situ" aorto-iliac reconstruction using deep vein harvested from the single lower limb. Such procedures are rarely performed on an emergency basis, however, potential benefits may outweigh the risk of a more technically challenging procedure. In the postoperative course antimicrobial treatment against Staphylococcus aureus was continued for 12 weeks after surgery. There has been a good long-term patency during more than 5 years of follow-up with no signs of reinfection or degeneration of the graft.
Łukasz
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Hapka
Grzegorz
G
Halena
D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000601:surgery*; D001019:Aortic Rupture / Q000150:complications* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy; D014654:Vascular Patency; D014680:Veins / Q000637:transplantation*