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[Inflammatory abdominal aortic aneurysm].

C Jego1, G Cellarier, H Thouard

  • 1Service de Cardiologie, HIA Sainte-Anne, 83800 Toulon Naval.

Journal Des Maladies Vasculaires
|May 11, 2000
PubMed
Summary
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Inflammatory abdominal aortic aneurysms can cause hydronephrosis. Corticosteroids may reduce inflammation, aiding surgical repair of aortic aneurysms and relieving ureteral obstruction.

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Radiology

Background:

  • Abdominal aortic aneurysms (AAAs) can present with vague symptoms, including abdominal pain and weight loss.
  • Inflammatory AAAs (IAAA) are a subset characterized by periaortic inflammation, potentially causing extrinsic compression of adjacent structures.
  • Left hydronephrosis secondary to ureteral compression is a rare but serious complication of IA AA.

Observation:

  • A 58-year-old male presented with abdominal pain and weight loss.
  • Physical examination revealed an enlarged kidney; abdominal echography demonstrated left hydronephrosis due to ureteral compression.
  • Computed tomography (CT) scan suggested an inflammatory abdominal aortic aneurysm.

Findings:

  • Laboratory tests indicated an inflammatory syndrome.

Related Experiment Videos

  • Treatment with corticosteroids led to symptom regression and resolution of ureteral obstruction.
  • This allowed for successful aneurysmectomy and prosthesis replacement without the need for ureterolysis.

    • Implications:

    • Preoperative radiological diagnosis of the inflammatory nature of abdominal aortic aneurysms is crucial.
    • Corticosteroid therapy may facilitate surgical repair by reducing periaortic inflammation and relieving ureteral obstruction in uncomplicated IA AA cases.
    • This approach can simplify surgical procedures and potentially improve patient outcomes.