Concomitant mycotic abdominal aortic aneurysm and lumbar tuberculous spondylitis with cauda equina syndrome: a rare condition — a case report and literature review

Pluemvitayaporn, Tinnakorn; Jindahra, Sarun; Pongpinyopap, Warongporn; Kunakornsawat, Sombat; Thiranon, Chaiyot; Singhatanadgige, Weerasak; Uthaipaisanwong, Apinan

doi:10.1038/s41394-018-0047-x

Cited by 8 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pseudoaneurysm may develop adjacent to the eroded vertebral body,which greatly increases the risk of rupture during surgery. It was reported that an abdominal aortic aneurysm was iatrogenically ruptured during surgery for lumbar tuberculous spondylitis with psoas abscess [23]. In one case of this study, the patient's aortic aneurysm was found during thoracic spine tuberculosis surgery.…”

Section: Discussionmentioning

confidence: 56%

CT Imaging Manifestations of Tubercular Aortic Aneurysm

Xing

Sun

Chen

et al. 2021

Preprint

View full text Add to dashboard Cite

Tubercular aortic aneurysm is a rare complication of tuberculosis but associated with very high mortality. Early diagnosis is critical, however, it is challenging due to nonspecific symptoms. This study summarized the CT features of tubercular aortic aneurysm in order to assist timely clinical diagnosis. Seventeen patients with confirmed tubercular aortic aneurysm between 2016 and 2020 were included in this study. The clinical manifestations, past medical history, laboratory and imaging examinations, treatments and other data were collected. CT angiography was routinely performed in all patients. Clinical and CT imaging data was collected and analyzed. All tuberculous aneurysms were pseudoaneurysms, which were located in the thoracic aorta, abdominal aorta, junction of thoracic and abdominal aorta or iliac aorta. The shapes of aneurysms were saccular or lobular. The diameter of aneurysm ranged from 30 to 120 mm. Thirteen patients had atherosclerosis. Mural thrombus was shown in 14 patients. Twelve patients showed enlarged lymph nodes which were found closely related to the aneurysm. Nine patients had tuberculous spondylitis including tuberculosis of thoracic lumbar and lumbosacral spine. Psoas abscess was showed in four patients and iliopsoas abscess was in one patient. Compared with other infectious aneurysms, tuberculous aneurysms typically show more cystic and lobulated shapes on CT scan, which are imaged as poured and unstressed. Another point of differential diagnosis is that the surrounding tissues and adjacent organs of tubercular aneurysms are usually infected with tuberculosis and most of them are accompanied by other sites of tuberculosis.

show abstract

Section: Discussionmentioning

confidence: 56%

CT Imaging Manifestations of Tubercular Aortic Aneurysm

Xing

Sun

Chen

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The patient underwent total arch replacement, started with a fixed dose of ATT and fully recovered. Endovascular stent graft implantation proved to be an ultimate option for TBAA treatment in a 79-year-old male from Thailand [ 25 , 40 ] . The patient underwent posterior decompressive laminectomy and showed a gradual improvement in motor power.…”

Section: Discussionmentioning

confidence: 99%

“…The patient underwent posterior decompressive laminectomy and showed a gradual improvement in motor power. Finally, he was on continuous treatment with antituberculous chemotherapy for one year and was completely recovered [ 40 ] .…”

Section: Discussionmentioning

confidence: 99%

Tuberculous Aortic Aneurysm - A Review

Altoijry¹

2022

Braz J Cardiovasc Surg

View full text Add to dashboard Cite

“…Since Long et al [8] reviewed advances in tuberculous mycotic aneurysm of the aorta in 1999, only 23 patients with tuberculous pseudoaneurysm were reported, of whom 22 had pseudoaneurysm secondary to tuberculous spondylitis. [5–7,9–20] We reviewed these case reports and found only 3 patients with a TAA rupture during the surgery (Table 1). [5–7] Together with the present case, a total of only 4 cases have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…[5–7,9–20] We reviewed these case reports and found only 3 patients with a TAA rupture during the surgery (Table 1). [5–7] Together with the present case, a total of only 4 cases have been reported.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of a ruptured thoracic aortic pseudoaneurysm secondary to Pott disease during a spine surgery

Sun

et al. 2019

Medicine

View full text Add to dashboard Cite

Rationale: The coexistence of a tuberculous aortic pseudoaneurysm and Pott disease in patients with a history of tuberculosis (TB) is relatively rare, and the treatment strategies remain still controversial. Patient concerns: A 57-year-old female patient with a history of primary pulmonary TB presented with symptoms of breathlessness, chest pain, weight loss, and fever. Magnetic resonance imaging (MRI) and computed tomography (CT) showed a thoracic aortic pseudoaneurysm secondary to Pott disease at T11/12 level. Diagnoses: Tuberculous pseudoaneurysm at the descending thoracic aorta associated with tuberculous vertebral osteomyelitis. Interventions: We originally planned a combined surgery consisting of posterior spine stabilization, anterior excision of the infected field, and aortic reconstruction. When we surgically stabilized the posterior spine, unexpectedly, the pseudoaneurysm ruptured. Immediately, we terminated the surgery and appropriately placed an endovascular stent graft, which successfully rescued the patient. Outcomes: When the patient's conditions were stable, we anteriorly debrided all infected tissues and then performed a spinal fusion by grafting autologous iliac bone. After the debridement and spinal fusion, we arranged a 1-year anti-tuberculous chemotherapy for this patient and performed a 24-month follow-up. This patient had no signs of recurrent infection during the follow-up. Lessons: For the patients with tuberculous aortic aneurysm(s) complicated with vertebral osteomyelitis, the endovascular repair of an aneurysm(s) should be considered a conventional therapy before the spine surgery, lowering the risk of aortic aneurysm rupture. Meanwhile, minimally invasive endovascular stent graft combined with anti-tuberculosis drugs may be considered one of the therapeutic regimens for the patients whose conditions are not suitable for open surgery, such as age, weakness, or severe organ failure.

show abstract

Concomitant mycotic abdominal aortic aneurysm and lumbar tuberculous spondylitis with cauda equina syndrome: a rare condition — a case report and literature review

Cited by 8 publications

References 20 publications

CT Imaging Manifestations of Tubercular Aortic Aneurysm

CT Imaging Manifestations of Tubercular Aortic Aneurysm

Tuberculous Aortic Aneurysm - A Review

Endovascular treatment of a ruptured thoracic aortic pseudoaneurysm secondary to Pott disease during a spine surgery

Contact Info

Product

Resources

About