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Inflammatory aneurysms of the abdominal aorta
H H Moosa1, A B Peitzman, D L Steed
1Department of Surgery, University of Pittsburgh School of Medicine, PA.
Archives of Surgery (Chicago, Ill. : 1960)
|June 1, 1989
Summary
Inflammatory abdominal aortic aneurysms (IAAAs) present unique inflammation and involve adjacent organs. Diagnosis and definition are challenging due to their varied presentation.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Urology
Background:
- Inflammatory abdominal aortic aneurysms (IAAAs) are distinct from typical atherosclerotic aneurysms.
- IAAAs present unique clinical and physical characteristics.
- Diagnosis and definition of IAAAs can be challenging due to varied inflammation and involvement of adjacent structures.
Purpose of the Study:
- To characterize the clinical presentation and intraoperative findings of inflammatory abdominal aortic aneurysms.
- To assess the involvement of adjacent retroperitoneal structures in IAAAs.
- To evaluate the outcomes of surgical repair for IAAAs.
Main Methods:
- Retrospective review of 265 patients undergoing abdominal aortic aneurysm repair.
- Identification and analysis of 19 cases of IAAAs.
- Documentation of clinical symptoms, intraoperative findings, and adjacent structure involvement.
Main Results:
- IAAAs were identified in 7.2% of patients undergoing abdominal aortic aneurysm repair.
- 63% of patients with IAAAs presented with symptoms, including one rupture.
- Dense periaortic inflammation was observed in all IAAAs, frequently involving the duodenum (79%), left renal vein (32%), and ureter (26%).
Conclusions:
- IAAAs exhibit significant periaortic inflammation and can involve adjacent retroperitoneal structures.
- The spectrum of inflammation and involvement varies, complicating diagnosis.
- Elective resection of IAAAs demonstrated high survival rates (94%).