1/31. Primary aorto-duodenal fistula secondary to infected abdominal aortic aneurysms: the role of local debridement and extra-anatomic bypass.Gastrointestinal bleeding secondary to spontaneous rupture of an infected abdominal aortic aneurysm into the duodenum is a rare and highly lethal clinical occurrence, representing roughly a third of all primary aortoduodenal fistulas. diagnosis is problematic due to the subtleties in the clinical presentation and course, and surgical treatment is usually delayed, representing a challenge even for the experienced vascular surgeon. The overall mortality is over 30% and the operative approaches are still controversial. Two cases of ruptured infrarenal aortic aneurysms complicated with aortoduodenal fistula were recently treated at our institution. Bacterial aortitis was documented by arterial wall cultures positive for klebsiella and salmonella species respectively. The clinical courses and outcomes of the two patients (one survivor ) treated with retroperitoneal debridement and extra-anatomic bypass and a review of the modern surgical treatment are herein described.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
2/31. endarteritis and false aneurysm complicating aortic coarctation.We report a tricky case of endocarditis because of the localization, aortic coarctation, and the pathogenic bacteria actinobacillus actinomycetemcomitans. Furthermore, we underline the leading role of transesophageal echocardiography in the diagnosis of aortic endarteritis. First, aortitis was treated with antibiotics and, second, successfully operated on.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
3/31. Primary aortoenteric fistula related to septic aortitis.CONTEXT: Primary aortoenteric fistulas usually result from erosion of the bowel wall due to an associated abdominal aortic aneurysm. A few patients have been described with other etiologies such as pseudoaneurysm originating from septic aortitis caused by salmonella. OBJECTIVE: To present a rare clinical case of pseudoaneurysm caused by septic aortitis that evolved into an aortoenteric fistula. CASE REPORT: A 65-year-old woman was admitted with salmonella bacteremia that evolved to septic aortitis. An aortic pseudoaneurysm secondary to the aortitis had eroded the transition between duodenum and jejunum, and an aortoenteric fistula was formed. In the operating room, the affected aorta and intestinal area were excised and an intestine-to-intestine anastomosis was performed. The aorta was sutured and an axillofemoral bypass was carried out. In the intensive care unit, the patient had a cardiac arrest that evolved to death.- - - - - - - - - - ranking = 8keywords = aortitis (Clic here for more details about this article) |
4/31. Reconstruction of heavily calcified aorta and its visceral branches without extracorporeal circulation.A 61-year-old Japanese female was referred to our hospital for surgical treatment of a localized heavily calcified abdominal aorta. Preoperative angiograms and computed tomograms revealed severe stenosis of the aorta, resembling a slit. Bypass grafting between the thoracic and abdominal aorta was successfully performed together with the reconstruction of the celiac artery, superior mesenteric artery, and bilateral renal arteries without extracorporeal circulation. Postoperative angiograms showed patency of the graft and branches. A localized heavily calcified abdominal aorta is relatively rare, and the cause of this entity might be Takayasu's aortitis.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
5/31. Primary aorto-esophageal fistula due to Takayasu's aortitis.BACKGROUND: Aneurysmal dilatation in Takayasu's arteritis is a recognized complication; however, fistula formation, especially to the esophagus, is very rare. methods: A 22-year-old male presented with severe hematemesis. Investigation by means of esophagogastroscopy and CT scan revealed a saccular aneurysm in the proximal descending aorta with communication to the esophagus. The patient was taken to theater, the aneurysm excised and replaced by a graft. RESULTS: Gross examination of the aneurysm showed multiple points of outpouching from the aneurysm. Histopathological examination of the showed marked intimal fibromyxoid thickening, loss of outer medial muscle and elastic fibers and marked fibrosis of the adventitial layer. The histological features were in keeping with Takayasu's arteritis. No evidence of tuberculosis was noted. CONCLUSIONS: This case illustrates an unusual complication of Takayasu's arteritis, in the form of a fistula between the aorta and the esophagus, which resulted in massive hematemesis and the ultimate demise of the patient.- - - - - - - - - - ranking = 4keywords = aortitis (Clic here for more details about this article) |
6/31. Atherosclerotic pseudoaneurysm of the ascending aorta.Pseudoaneurysms in the ascending aorta most commonly occur as a complication of surgical procedures at this site. They have also been reported in association with trauma, infection, aortitis, and other disorders. Pseudoaneurysm formation in the descending aorta or arch may occur as a result of penetrating ulcers in the presence of severe atherosclerotic plaque. Pseudoaneurysm as a result of atherosclerotic disease has only rarely been noted in the ascending aorta, where complex plaque is less common. We report here the finding with transesophageal echocardiography of a pseudoaneurysm in the ascending aorta as a result of atherosclerotic disease and penetrating ulcer.- - - - - - - - - - ranking = 1keywords = aortitis (Clic here for more details about this article) |
7/31. Aorto-oesophageal fistula complicating tuberculous aortitis. A case report.A case of massive upper gastro-intestinal haemorrhage in a Black woman owing to tuberculous aorto-oesophageal fistula is reported. The literature is reviewed and the clinical presentation discussed. This possibly represents only the second case of aorto-oesophageal fistula complicating postprimary tuberculosis to appear in medical literature.- - - - - - - - - - ranking = 4keywords = aortitis (Clic here for more details about this article) |
8/31. Idiopathic aortitis with calcification of ascending aorta, and aortic and mitral valves.A young woman with unexplained radiographic calcification of the ascending aorta was found at necropsy to have healed idiopathic aorititis. Calcification also involved the aortic valve which was stenosed and the mitral valve. death was the result of infective endocarditis of these valves with aortic ring abscess, rupture of aortic root, and cardiac tamponade.- - - - - - - - - - ranking = 4keywords = aortitis (Clic here for more details about this article) |
9/31. Reiter's aortitis with pericardial fluid, heart block and neurologic manifestations.A man who presented with Reiter's triad and keratoderma blenorrhagicum followed by cardiac manifestations is reported. He developed mild aortic insufficiency, A-V block and pericardial effusion. Painful ophthalmoplegia occurred 5 months later with exacerbation of the cardiac complications as corticosteroids were being tapered. retreatment with high dose corticosteroids resulted in a remarkable remission of the neurologic complications and stabilization of his cardiac manifestations now maintained for 3 years.- - - - - - - - - - ranking = 4keywords = aortitis (Clic here for more details about this article) |
10/31. Primary aortoduodenal fistula due to septic aortitis.We report the second case of a primary aortoenteric fistula resulting from septic aortitis with a contained aortic leak into the retroperitoneum and finally erosion into the duodenum. An emergency laparotomy revealed a fistula between the third part of the duodenum and a decompressed sac (false aneurysm) arising from a nonaneurysmal, grossly infected pararenal aorta. The purpose of this report is to present this rare case in detail and to review primary aortoenteric fistulas reported in the English language literature. Most fistulas form in association with an abdominal aortic aneurysm and rarely are due to infection. Only 6% of patients presented with the classic triad of abdominal pain, a palpable mass, and gastrointestinal bleeding. Although 29% of patients presented with massive hemorrhage, adequate time usually existed for surgical treatment of these complications. A patient with ill-defined abdominal pain and fever who suddenly develops a palpable abdominal mass should have an emergency ultrasound or CT scan to exclude the possibility of an infected aortic aneurysm or a contained rupture of an infected nonaneurysmal aorta. If the symptoms are associated with bleeding and the patient is hemodynamically stable, emergent endoscopy should also be performed. If a primary aortoenteric fistula or an aortic pseudoaneurysm is confirmed, emergent surgery should be undertaken to avoid rupture into the bowel or retroperitoneum.- - - - - - - - - - ranking = 5keywords = aortitis (Clic here for more details about this article) |
| | Next -> |