'No-Touch' isolation procedure for ruptured mycotic abdominal aortic aneurysm

Area of Science:

• Vascular Surgery
• Infectious Diseases
• Abdominal Aortic Aneurysm

Background:

• Mycotic abdominal aortic aneurysms (MAAA) are rare but life-threatening conditions.
• Enterobacter cloacae is an opportunistic pathogen that can cause serious infections.
• Rupture of a mycotic abdominal aortic aneurysm requires urgent surgical intervention.

Observation:

• A 66-year-old male presented with a ruptured infra-renal mycotic abdominal aorta due to Enterobacter cloacae infection.
• The surgical strategy included an extra-anatomic bypass prior to laparotomy to prevent bacterial contamination.
• The procedure involved complete resection of the infected aorta, tapering of arterial stumps, omental wrapping, and ligation with Teflon tapes.

Findings:

• Successful surgical repair of the ruptured mycotic abdominal aorta was achieved.
• The patient remained alive and well one year post-surgery, indicating a favorable long-term outcome.
• The implemented surgical technique effectively managed the infection and restored aortic integrity.

Implications:

• This case highlights the efficacy of a staged surgical approach in managing ruptured mycotic abdominal aortic aneurysms.
• The described technique provides a valuable option for complex aortic infections, minimizing contamination risks.
• Further research into optimal management strategies for mycotic aortic aneurysms is warranted.