title: Juxtarenal Mycotic Aneurysm as a Complication of Acute Exacerbation of Chronic Cholecystitis Treated by Resection and Replacement by a Fresh Allograft.
abstract: We present a case of a female patient with infectious (mycotic) juxtarenal abdominal aneurysm with atypical symptoms beginning as acute exacerbation of chronic cholecystitis. Apart from common antibiotic treatment, the patient successfully underwent resection of the diseased segment and replacement by a fresh allograft in order to reduce the risk of infection of the graft, but with the need of subsequent life-long immunosuppressive therapy. Perioperative monitoring of the spinal cord by near infrared spectroscopy was used to identify possible spinal ischemia. The choice of the fresh allograft was based on our experience supported by review of the literature.
authors.affiliation: 2nd Department of Surgery - Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Grus
authors.affiliation: Department of Radiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic. lambert.lukas@gmail.com.
authors.forename: Lukáš
authors.initials: L
authors.lastname: Lambert
authors.affiliation: 2nd Department of Surgery - Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Vilém
authors.initials: V
authors.lastname: Rohn
authors.affiliation: 2nd Department of Surgery - Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Klika
authors.affiliation: 4th Department of Medicine - Department of Gastroenterology and Hepatology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Grusová
authors.affiliation: Department of Anaesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Michálek
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D002764:Cholecystitis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D062072:Patient Acuity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Abdominal aorta; Allograft; Cholecystitis; Mycotic aneurysm; Near infrared spectroscopy