1/16. Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience.To define the epidemiology, pathogenesis, pathology, presentation, and management of tuberculous mycotic aneurysm of the aorta (TBAA) in the therapeutic era, we reviewed all of the cases reported in the English language literature from 1945 to the present. To the 39 cases in the published literature, we add two cases of our own. Although it is exceedingly rare, the prevalence of this lesion has remained relatively constant. In 75% of the cases, TBAA appeared to result from erosion of the aortic wall by a contiguous focus; 25% from direct seeding of the aortic intima or of the adventitia or media (via the vasa vasorum). Most of the aneurysms were saccular (90%) and false (88%). The thoracic and abdominal aortas were affected with equal frequency. The mean ( /- SD) age of the patients was 50 /-16 years. Twenty-two were men, and 19 were women. In 63% of the cases, tuberculosis (TB) was diagnosed at presentation. Disseminated TB was present in 46% of the cases. One or more of three clinical scenarios suggested TBAA: persistent pain, major bleeding, and a palpable or radiographically visible para-aortic mass, especially if it is expanding or pulsatile. In turn, each of these findings suggested a complication of TBAA that may be an indication for surgical intervention. Among the patients who were offered both medical and surgical treatment, 20 of 23 (87%) survived. Among those who were offered only one form of treatment or were offered no treatment at all there were no survivors. Both in situ reconstruction with a prosthetic graft, and extra-anatomic bypass appeared to offer excellent results, provided that an effective regimen of antituberculous drugs was delivered postoperatively. We offer our conclusions: (1) symptomatic TBAA is a rare but uniformly fatal lesion if not diagnosed promptly, (2) in the context of active TB, and especially miliary TB, TBAA should be suspected whenever one or more of the three clinical scenarios are present, and (3) combined medical and surgical therapy appears to offer the best chance of a cure.- - - - - - - - - - ranking = 1keywords = mycotic aneurysm (Clic here for more details about this article) |
2/16. Tuberculous pseudoaneurysm of the femoral artery: a case report.Pseudoaneurysm of the femoral artery is an extremely rare complication of tuberculosis. We present a case of tuberculous femoral pseudoaneurysm that was successfully treated with resection, direct anastomosis, and postoperative antituberculous chemotherapy.- - - - - - - - - - ranking = 0.00070920404636154keywords = artery (Clic here for more details about this article) |
3/16. Tuberculous aortitis with an aortoduodenal fistula presenting as recurrent gastrointestinal bleeding.Tuberculous aortitis with a tuberculous mycotic aneurysm and an aortoduodenal fistula was diagnosed in a 38-year-old man with tuberculous cervical lymphadentitis and a 3-month history of recurrent gastrointestinal bleeding, in whom extensive investigation of the digestive tract had not revealed a bleeding lesion. Either by septic embolism or by direct extension from a neighboring focus, tuberculous infection can cause a mycotic aortic aneurysm with subsequent fistulation to the duodenum.- - - - - - - - - - ranking = 0.2keywords = mycotic aneurysm (Clic here for more details about this article) |
4/16. Tuberculous aneurysm of the abdominal aorta: endovascular repair using stent grafts in two cases.Tuberculous aneurysm of the aorta is exceedingly rare. To date, the standard therapy for mycotic aneurysm of the abdominal aorta has been surgery involving in-situ graft placement or extra-anatomic bypass surgery followed by effective anti-tuberculous medication. Only recently has the use of a stent graft in the treatment of tuberculous aortic aneurysm been described in the literature. We report two cases in which a tuberculous aneurysm of the abdominal aorta was successfully repaired using endovascular stent grafts. One case involved is a 42-year-old woman with a large suprarenal abdominal aortic aneurysm and a right psoas abscess, and the other, a 41-year-old man in whom an abdominal aortic aneurysm ruptured during surgical drainage of a psoas abscess.- - - - - - - - - - ranking = 0.2keywords = mycotic aneurysm (Clic here for more details about this article) |
5/16. Tuberculous renal artery aneurysm: a case report.Tuberculous renal artery aneurysm in a 36-year-old Black man is reported. This is thought to be the first case reported in the English language medical literature. The literature is reviewed with regard to presentation and management of renal artery aneurysm in general, with specific reference to tuberculous arterial infection.- - - - - - - - - - ranking = 0.0074426848309316keywords = artery aneurysm, artery (Clic here for more details about this article) |
6/16. Mycotic aneurysm of the popliteal artery as a complication of intravesical BCG therapy for superficial bladder cancer. Case report and literature review.A 67-year-old man was treated with maintenance intravesical BCG for superficial bladder cancer. As a culture-proven complication of this therapy, he developed general malaise, high fever, granulomatous hepatitis and a mycotic aneurysm in his left knee. All complications were treated successfully with antituberculous therapy. No vascular surgery was necessary. This case report again stresses the necessity to recognise complications of BCG treatment and to start adequate therapy as soon as possible.- - - - - - - - - - ranking = 0.20056736323709keywords = mycotic aneurysm, artery (Clic here for more details about this article) |
7/16. Tuberculous aneurysm of the supraceliac aorta--a case report.Significant vascular complications are rare following systemic infections with mycobacterium tuberculosis (TB). This report describes a 33-year-old man who presented with a short history of abdominal discomfort and febrile episodes with no prior history of infection with TB. Ultrasound, CT scan, and aortography confirmed the presence of a pseudoaneurysm originating from the posterior aspect of the supraceliac aorta at the level of the diaphragm. Via a full thoracoabdominal approach, periaortic inflammatory tissue and the aortic wall itself were debrided, and repair of the pseudoaneurysm was achieved with a synthetic patch. mycobacterium tuberculosis was isolated from the aortic wall, and anti-TB medications were instituted. Postoperatively the patient did well and was discharged after 14 days. As illustrated by this case, tuberculous mycotic aneurysms of the aorta are optimally treated with a combination of medical and surgical therapy, and early diagnosis is essential to ensure survival.- - - - - - - - - - ranking = 0.2keywords = mycotic aneurysm (Clic here for more details about this article) |
8/16. Tuberculous pseudoaneurysm of the celiac artery. A case report.We report a case of tuberculous pseudoaneurysm in the neck of the celiac artery involving the aorta. recurrence of the aneurysm occurred after attempted direct repair. Therefore redo-surgery was performed, which involved resection of aneurysm and removal of the infected tissue with bilateral axillofemoral bypass.- - - - - - - - - - ranking = 0.00070920404636154keywords = artery (Clic here for more details about this article) |
9/16. A patient with insidious onset of exertional dyspnoea.The case history is presented of a 42 year old woman with pulmonary artery occlusion due to tuberculous vasculitis that masqueraded as chronic pulmonary artery embolism and led to severe life threatening haemoptysis necessitating emergency pneumonectomy. It is concluded that obliterative tuberculous endarteritis of the pulmonary arteries should be considered in the differential diagnosis of any acquired obstruction of pulmonary arteries.- - - - - - - - - - ranking = 0.00028368161854461keywords = artery (Clic here for more details about this article) |
10/16. Tuberculous pericardial effusion after coronary artery bypass graft.We describe a case of a recurrent pericardial effusion after coronary artery bypass grafting. This was initially considered to be due to post-pericardiotomy syndrome, but was later treated empirically as tuberculosis. After definitive surgery for this condition, pericardial histology and immunohistochemistry confirmed the diagnosis of tubercular pericarditis. At 4-months follow-up, while continuing anti-tuberculous therapy and corticosteroids, the patient showed consistent improvement without further recurrence of his pericardial effusion. Local reactivation of tuberculosis after pericardiotomy has not been previously reported and merits careful consideration in population groups in which tuberculosis is highly endemic.- - - - - - - - - - ranking = 0.00070920404636154keywords = artery (Clic here for more details about this article) |
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