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Repetitive contained rupture of an infected abdominal aortic aneurysm with concomitant vertebral erosion

Hiroshi Yamamoto1, Fumio Yamamoto, Hiroshi Izumoto

  • 1Department of Cardiovascular Surgery, Akita University School of Medicine, Hondo 1-1-1, Akita, Japan.

Annals of Vascular Surgery
|May 18, 2010
PubMed

Insights

This case study details surgical intervention for recurrent infected abdominal aortic aneurysm (AAA) rupture with vertebral erosion. Prompt surgical treatment is crucial for preventing re-rupture and spinal instability.

Area of Science:

  • Vascular Surgery
  • Infectious Disease
  • Spinal Surgery

Background:

  • Infected abdominal aortic aneurysms (AAA) pose significant surgical challenges.
  • Vertebral erosion is a rare but serious complication of infected AAA.

Observation:

  • A 59-year-old man presented with symptoms of an infected AAA rupture.
  • Initial conservative management was followed by recurrent rupture and lumbar vertebral erosion.
  • Gram-positive Streptococcus was identified in the infected hematoma.

Findings:

  • Surgical debridement of eroded vertebrae and in situ graft replacement of the AAA were performed.
  • The patient experienced an uneventful postoperative recovery with no signs of further deterioration at 12 months.
  • Repetitive contained AAA rupture may represent a distinct clinical entity.

Implications:

  • Vertebral erosion in infected AAA may be primarily infection-driven, not solely due to mass effect.
  • Surgical intervention is vital for managing recurrent infected AAA rupture and associated vertebral destruction.
  • This case highlights the importance of timely surgical treatment to prevent catastrophic outcomes.

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