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Large tender abdominal aortic aneurysm presented with concomitant acute appendicitis: a case report
Ahmad Al Samaraee1, James McCaslin, Vish Bhattacharya
1Department of General Surgery, Queen Elizabeth Hospital, Queen Elizabeth Avenue, Sheriff Hill, Gateshead, Tyne & Wear, NE9 6SX, UK. ahmadas@doctors.org.uk.
Cases Journal
|February 3, 2009
Summary
Managing abdominal aortic aneurysms with acute appendicitis requires careful surgical planning. A two-stage approach, prioritizing appendectomy before aneurysm repair, can safely manage this dual emergency and prevent graft infection.
Area of Science:
- Vascular Surgery
- Gastrointestinal Surgery
- Emergency Medicine
Background:
- Management of concurrent abdominal aortic aneurysm (AAA) and intra-abdominal pathology is challenging.
- Surgeons often avoid simultaneous procedures due to graft infection risk.
- Urgent AAA repair with sepsis-risk pathologies presents a significant dilemma.
Purpose of the Study:
- To report an unusual case of large AAA with acute appendicitis requiring urgent intervention.
- To discuss the surgical strategy for managing concurrent life-threatening conditions.
Main Methods:
- A 66-year-old male presented with large AAA and acute appendicitis.
- Diagnosis confirmed via CT scan.
- Underwent a two-stage operation: appendectomy followed by open AAA repair.
Main Results:
- The patient experienced an uneventful recovery.
- Achieved a full return to normal life post-operatively.
- The two-stage approach successfully managed both pathologies while mitigating infection risk.
Conclusions:
- The incidence of AAA with coexisting intra-abdominal pathology is rising.
- Simultaneous surgery for AAA and sepsis-risk conditions should be avoided.
- Prioritize the most life-threatening condition, followed by the second pathology, preferably during the same admission.
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