Tuberculous Aneurysm of the Supraceliac Aorta

Abstract

Significant vascular complications are rare following systemic infections with Mycobacterium tuberculosis (TB). This report describes a 33-year-old man who presented with a short history of abdominal discomfort and febrile episodes with no prior history of infection with TB. Ultrasound, CT scan, and aortography confirmed the presence of a pseudoaneurysm originating from the posterior aspect of the supraceliac aorta at the level of the diaphragm. Via a full thoracoabdominal approach, periaortic inflammatory tissue and the aortic wall itself were debrided, and repair of the pseudoaneurysm was achieved with a synthetic patch. Mycobacterium tuberculosis was isolated from the aortic wall, and anti-TB medications were instituted. Postoperatively the patient did well and was discharged after 14 days. As illustrated by this case, tuberculous mycotic aneurysms of the aorta are optimally treated with a combination of medical and surgical therapy, and early diagnosis is essential to ensure survival.

Selective jejunal artery pseudoaneurysm embolization in a patient with massive gastrointestinal bleeding due to intestinal tuberculosis

“…Pseudoaneurysms due to intestinal tuberculosis have been described previously in the aorta, the femoral artery and the visceral arteries, such as celiac, hepatic, gastroduodenal and superior mesenteric artery (3)(4)(5)(6)(7)(8).…”

Treatment of tuberculous aortic pseudoaneurysm associated with vertebral tuberculosis

“…In the study by Long et al, [ 14 ] the pseudoaneurysms in 19 patients were located in the thoracic aorta, 21 in the abdominal aorta, and only 1 at the junction of the thoracic and abdominal aorta. Of the 15 new cases added by Forbes et al, [ 27 ] 9 were located in the thoracic aorta, 5 in the abdominal aorta, and 1 at the junction of thoracic and abdominal aorta. We found tuberculous pseudoaneurysms located in the thoracic aorta, abdominal aorta, and junction of thoracic and abdominal aorta in 8, 11, and 3 cases, respectively; the 3 cases in our study were all located in the thoracic aorta.…”

Internal mammary artery pseudoaneurysm: A rare fatal complication of tubercular empyema

“…[5] M. tuberculosis can primarily involve the vessel wall in the area of active infection which may result in arteritis, thrombosis or the pseudoaneurysm formation. [16] Replacement of adventitia and media by the granulation tissue leads to progressive weakening of the arterial wall. Fibrin gradually replaces the granulation tissue which results in thinning of the arterial wall, pseudoaneurysm formation and subsequent rupture.…”