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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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Infected Abdominal Aortic Aneurysm After Transrectal Ultrasound-Guided Biopsy of the Prostate: A Report of Two Cases

Haya Husam Al-Ani1, Manar Khashram1, Anastasia Dean1

  • 1Department of Vascular Surgery, Auckland City Hospital, Auckland, New Zealand.

Annals of Vascular Surgery
|August 6, 2019
PubMed

Insights

Primary infected abdominal aortic aneurysms (AAAs) are rare but serious complications following transrectal ultrasound-guided prostate biopsy. This report details two cases of Escherichia coli infection in AAAs shortly after biopsy, highlighting potential risks.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Urology

Background:

  • Primary infected abdominal aortic aneurysm (AAA) is a rare but life-threatening condition.
  • Transrectal ultrasound-guided (TRUS) prostate biopsy is an increasingly common urological procedure.

Observation:

  • Two patients developed infected AAAs within 10 days of undergoing TRUS prostate biopsy.
  • Both patients presented with sepsis and back pain, with rapid aneurysm expansion noted in one case.
  • Aortic tissue biopsies confirmed Escherichia coli infection in both cases.

Findings:

  • Infection of the abdominal aorta occurred shortly after prostate biopsy, suggesting a potential link.
  • One patient survived surgical intervention, while the other succumbed to aneurysm rupture.
  • Pre-existing, undiagnosed aortic aneurysms may be a risk factor for post-biopsy infection.

Implications:

  • TRUS prostate biopsy may pose a risk for developing infected AAAs, particularly in patients with undiagnosed aneurysms.
  • Early recognition and prompt management are crucial for improving outcomes in infected AAA cases.
  • Further research is warranted to elucidate the pathophysiology and establish preventative strategies.

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