Inflammatory aneurysms of the abdominal aorta

Abstract

SUMMARYTwo hundred and seventeen patients presenting with abdominal aneurysms in the Department of Surgery at the Manchester Royal Infirmary between the years 1958-69 were surveyed retrospectively.One hundred and eighty-seven of the patients underwent operation for resection of their aneurysms ; of these, 19 (10 per cent) showed excessive thickening of the aneurysm walls and perianeurysmal adhesions at operation.Subsequent histological examination of the walls of these unusual aneurysms showed extensive active chronic inflammatory changes, including plasma-cell infiltration.This group of patients whose aneurysms we describe as 'inflammatory ' presented with different clinical features in comparison with the atherosclerotic group. Retrospective investigation has not yet revealed any aetiological factors. We feel that 'inflammatory' aneurysms are a discrete entity with significant differences from atherosclerotic aneurysms and previously described arteritis.T w o hundred and seventeen patients presented with abdominal aortic aneurysms at the University Department of Surgery at the Manchester Royal Infirmary over the period 1958-69 and of these, 187 underwent operative treatment with the intention of resection of their aneurysms.One hundred and sixty-eight patients were found to have aneurysms of the atherosclerotic type. I n the remaining 19 cases the aneurysms were unusually thick walled and surrounded by extensive fibrous adhesions which made operative procedures much more difficult. On 2 occasions aneurysms described at operation as 'surrounded by dense fibrous tissue' and ' densely adherent ', respectively, were encountered before this investigation was undertaken. These 2 cases were probably of the 'inflammatory' type, but owing to the lack of histological verification have not been included in the series. Specimens of the aneurysm walls from this group of 19 cases were subjected to detailed histological examination and bacterial culture, the case records of all 19 patients were reviewed, and haematological, biochemical, and immunological investigations were carried out on the surviving patients.Despite their striking operative appearance and significant incidence these aortic lesions, as far as we are aware, have not been previously described.* Requests for reprints to be sent to Mr.

Long‐term Outcome after Inflammatory Abdominal Aortic Aneurysm Repair: Case‐matched Study

“…It should be noted that the number of patients in this study is fairly small because of the strict criteria adopted to define the inflammatory AAA; our prevalence is in fact relatively low (2.8%) compared with other previously reported experiences [2,3,7,8,17]. However, the selection procedure allowed us to obtain two groups with similar preoperative risk factors followed by periodic instrumental examination and to make the groups strictly comparable.…”

ANCA‐positive periaortic vasculitis: does it fall within the spectrum of vasculitis?

“…Moreover, a necrotizing vasculitis of aortic vasa vasorum is described in at least one-third of inflammatory aneurysms [13].…”

Inflammatory Abdominal Aortic Aneurysm Followed by Disseminated Intravascular Coagulation and Immune Thrombocytopenia.

“…IAAAis a new clinical entity that was first described by Walker et al (3). The disease is predominantly seen in males and shows a good clinical course.…”

“…Inflammatory abdominal aortic aneurysm (IAAA) has recently been recognized as a new clinical entity by its distinct characteristics including perianeurysmal fibrosis and a thickened aortic wall (1)(2)(3). The incidence of the disease among aortic aneurysms ranges from 2 to 15% (3)(4)(5)(6)(7)(8)(9).…”

“…The incidence of the disease among aortic aneurysms ranges from 2 to 15% (3)(4)(5)(6)(7)(8)(9). Weencountered a patient with IAAAwho had disseminated intravascular coagulation (DIC) and immune thrombocytopenic purpura (ITP).…”