[A case of tuberculous abdominal aortic aneurysm which ruptured and perforated the sigmoid]

Tuberculous aneurysm is a very rare disease and the prognosis is not good. The authors carried out an emergency abdominal section on a 48 year old patient who had a serious hematochezia and vasography was performed on the patient in order to diagnose the bleeding site. However, the patient had a second serious hematochezia during vasography and fell into the state of shock. Laparotomy revealed innumerable tubercular knobs were and a seemingly tuberculous abdominal aortic knob, which ruptured and perforated to the sigmoid. The aorta was clamped above and below the knob and the knob was sutured and partially removed. A by-pass operation using an artificial blood vessel was carried out and the sigmoid was removed. After operation, acute renal insufficiency developed and the patient died suddenly 13 days after operation. The cause of the death is unknown because we could not perform autopy on this patient. Pathology of the resected specimen of the aorta showed the rest from which bleeding had occurred and caseous necrosis, expansion of cell infiltration and Langhans giant cells. Pathological diagnosis of the specimen was tubercuous aortic aneurysm.