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Cryptic mycotic abdominal aortic aneurysms: diagnosis and management
American Journal of Surgery
|July 1, 1978
Summary
Cryptic mycotic abdominal aortic aneurysms, often caused by Salmonella, are increasing. Early diagnosis in patients with fever and abdominal pain is crucial for effective treatment and improved outcomes.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Radiology
Background:
- The incidence of cryptic mycotic abdominal aortic aneurysms (MAAA) has risen with increased antibiotic availability.
- Salmonella species are implicated in approximately 50% of MAAA cases.
Observation:
- MAAA should be suspected in patients presenting with fever of unknown origin, vague abdominal pain, and a developing pulsatile abdominal mass.
- Aortography can aid in diagnosing these aneurysms.
Findings:
- Unrecognized MAAA may be a source of postoperative graft infections, contrary to previous assumptions of external contamination.
- Successful treatment of infected infrarenal aortic aneurysms involves axillofemoral bypass grafting through uninfected tissue.
Implications:
- This study adds three surviving patients to the sixteen previously reported, highlighting treatment successes.
- Recognizing and diagnosing MAAA promptly is vital for patient survival and preventing complications like graft infections.
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