Scientific papersSurgical treatment of infected aneurysms and pseudoaneurysms of the thoracic and abdominal aorta
Section snippets
Patients and methods
Between December 1994 to January 2003, 10 consecutive patients with infected aneurysms of the thoracic and abdominal aorta were treated in the Division of Vascular Surgery, Department of Surgery, Queen Mary Hospital. The demographic data and investigation results especially bacteriology, surgical outcome, and follow-up data were reviewed. Patients were included only when the aneurysm had the typical appearance of an infected aneurysm on imaging (Fig. 1, Fig. 2), together with a positive
Patient demographics and presentation
There were six men and four women with a mean age of 63 years (range, 37–87 years). Four patients had ischemic heart disease, whereas each of hypertension, diabetes mellitus, or chronic renal impairment was present in three patients. Most patients were febrile or had a recent history of fever (80%). Abdominal and/or back pain was common (70%). Only half of the patients had palpable aneurysms/pseudoaneurysms. The typical triad of an infected aortic aneurysm (fever, pain, and pulsatile mass) was
Discussion
Infected aortic aneurysms used to be a deadly disease with high mortality and morbidity. The signs and symptoms are often nonspecific; the typical triad of infected aortic aneurysm, fever, pain, and pulsatile mass, was only present in less than half of our patients. One of the reasons is the propensity of paravisceral and thoracic involvement in infected aortic aneurysms [6], [7] that makes it difficult for access by physical examination. In a review of the 25-year experience at the Mayo’s
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2019, IDCasesCitation Excerpt :However, a combination of surgical and medical therapy may lead to a survival rate of 75%–100% before aneurysm formation, and 62% after an aneurysm has formed [13]. With medical treatment alone, mortality rates are quoted to be near 90% [14]. In this case, surgical intervention was not attempted given the patient‘s comorbidities and critical medical condition.
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