Inflammatory aneurysms of the abdominal aorta

Area of Science:

• Vascular Surgery
• Abdominal Aortic Aneurysm Research
• Inflammatory Conditions

Background:

• Abdominal aortic aneurysms (AAA) are a significant vascular condition.
• Inflammatory AAA (iAAA) represent a distinct subgroup with unique clinical and diagnostic challenges.
• Distinguishing iAAA from other pathologies is critical for appropriate management.

Purpose of the Study:

• To investigate the incidence and characteristics of iAAA.
• To evaluate diagnostic methods and potential pitfalls in iAAA diagnosis.
• To assess the outcomes of surgical management for iAAA.

Main Methods:

• Retrospective analysis of 268 abdominal aortic aneurysm surgeries over 5 years.
• Identification of cases with inflammatory features.
• Review of clinical presentation, diagnostic imaging (ultrasound, CT), and surgical outcomes.

Main Results:

• 15 out of 268 (5.6%) operated AAAs exhibited inflammatory features.
• Pain (back and abdominal) was the most common symptom (13 patients).
• Erythrocyte Sedimentation Rate (ESR) may aid pre-operative diagnosis.
• Imaging (Ultrasound, CT) can cause diagnostic confusion due to peri-aortic mass detection, mimicking lymphoma in two cases.
• No mortality or significant morbidity observed with adherence to surgical principles in the 15 iAAA patients.

Conclusions:

• Inflammatory AAA is an uncommon but distinct entity within AAA pathology.
• Clinical presentation and diagnostic imaging require careful interpretation to avoid misdiagnosis.
• ESR may be a valuable diagnostic marker.
• Surgical management following strict principles yields excellent outcomes for iAAA.