Abstract
A 58-year-old man given a diagnosis of Behçet disease and who had been followed up for 7 years, complained of fever, abdominal pain, and arthralgia. Computed tomography (CT) revealed a saccular abdominal aortic aneurysm up to 4.8 cm in maximum diameter. The aneurysm wall had a shaggy contrast effect and involved a low density area with an irregular septum implying an abscess cavity. Laboratory data showed moderate inflammation (WBC 11700/mm3, C-reactive protein 4.1 mg/dl). We gave antibiotics (IPM/CS 500 mg x 4/day) for 11 days preoperatively supposing aneurysmal infection. We performed aneurysm resection, debridement, and Y-graft replacement (right branch to left common iliac artery and left to right common femoral artery: passing through the retroperitoneal-suprapubic route). Horseshoe kidney was a burdensome factor in this case. The resection of the isthmus necessary for aortic clamping and closure, as well as accessory renal artery ligature might increase the surgical stress. Although the culture of aneurysm wall was negative, the possibility of aneurysm infection was thought to be high. Long term antibiotic prescription and the CT examination of the anastomotic site thought be necessary.
