[A case of perianeurysmal fibrosis treated by the thrombo-exclusion technique]

A very rare case of perianeurysmal fibrosis was presented. A 65-year old man was admitted with the complaint of abdominal pulsatile mass and intermittent claudication of right lower limb. Aortography revealed fusiform, calcified aneurysm of the infrarenal abdominal aorta and severe stenosis of right common iliac artery. CT scan demonstrated a soft tissue density structure around the aortic aneurysm which was enhanced after contrast medium injection. At surgery, the aneurysm had a thick, firm, smooth wall which was shiny white in appearance and adherent perianeurysmal fibrosis was marked. In order to avoid injury to surrounding tissue such as the duodenum or vena cava, thrombo-exclusion method was chosen. Histological examination of the aneurysmal wall showed fibrous tissue infiltrated with mononuclear cells such as lymphocytes and plasma cells. The postcontrast enhancement of aortic wall and perianeurysmal sheet disappeared on CT on the post-operative 57th day and no recurrence has been observed.