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Mycotic aneurysms in transplant patients
Archives of Surgery (Chicago, Ill. : 1960)
|April 1, 1976
Summary
Mycotic aneurysms in transplant patients often stem from perinephric wound infections. Prompt intervention like artery ligation is effective, but preventing infections is key to avoiding this dangerous complication.
Area of Science:
- Medicine
- Surgery
- Infectious Diseases
Background:
- Mycotic aneurysms are a rare but serious complication, particularly in transplant recipients.
- Perinephric wound infections are identified as a significant cause of mycotic aneurysms involving the iliac arteries.
Purpose of the Study:
- To report on the occurrence and management of mycotic aneurysms in transplant patients.
- To highlight the link between perinephric infections and mycotic aneurysm formation.
- To evaluate the efficacy of surgical interventions and preventative strategies.
Main Methods:
- Retrospective review of eight cases of mycotic aneurysms in seven transplant patients.
- Analysis of the causative factors, surgical treatments, and patient outcomes.
- Assessment of preventative measures for perinephric wound infections.
Main Results:
- Seven of eight mycotic aneurysms were associated with perinephric wound infections involving the iliac arteries.
- Simple ligation of the iliac artery was effective in most cases; one aortic aneurysm required bypass grafting.
- No instances of limb ischemia were observed, and mortality directly related to the aneurysm was low (two patients).
Conclusions:
- Preventing wound infections is crucial for avoiding mycotic aneurysms in transplant patients.
- Early detection via arteriography and prompt surgical management, including ligation or bypass grafting, are vital.
- Nephrectomy and meticulous wound care are recommended for established perinephric abscesses to prevent aneurysm development.