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Complicated chronic pancreatitis causing mycotic aortic aneurysm: in situ replacement with a cryopreserved aortic
C Knosalla1, M Bauer, Y g Weng
1Deutsches Herzzentrum Berlin and Abteilung für Allgemein-und Transplantationschirurgie, Universitätsklinkum Charité-Campus Virchow, Humboldt Universität zu Berlin, Berlin, Germany.
Abstract:
Mycotic aortic aneurysm, which resulted from infected pancreatic pseudocysts with retroperitoneal abscess, developed in a patient with chronic pancreatitis. The aorta was approached through median laparotomy. Necrotic material was debrided from the pancreatic pseudocysts, and the mycotic aneurysm was resected. The aorta was replaced in situ with a cryopreserved aortic allograft. This report discusses the rare complication of pancreatic pseudocysts, which affect the infrarenal abdominal aorta and cause a large mycotic aneurysm. This case suggests that the use of cryopreserved allografts is promising for in situ reconstruction, even in a grossly infected field.
Insights
A rare case of mycotic aortic aneurysm caused by infected pancreatic pseudocysts is presented. In situ aortic replacement with a cryopreserved allograft proved effective, even in a severely infected surgical field.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Infectious Diseases
Background:
- Chronic pancreatitis can lead to rare complications like infected pancreatic pseudocysts.
- These pseudocysts can extend to the retroperitoneum, potentially causing a mycotic aortic aneurysm.
Observation:
- A patient with chronic pancreatitis developed a mycotic aortic aneurysm secondary to infected pancreatic pseudocysts and retroperitoneal abscess.
- Surgical intervention involved median laparotomy for debridement and resection of the aneurysm.
Findings:
- The infrarenal abdominal aorta was successfully reconstructed in situ using a cryopreserved aortic allograft.
- This approach was feasible despite the presence of gross infection in the surgical field.
Implications:
- This case highlights the potential for pancreatic pseudocysts to cause devastating aortic infections.
- Cryopreserved aortic allografts demonstrate promise for in situ aortic reconstruction in complex, infected environments.