A Successful Case of Endovascular Aneurysm Repair and Abscess Drainage for a Rapidly Expanding Infectious Abdominal Aortic Aneurysm Associated with Psoas Abscess

Abstract

We report a successful case of endovascular aneurysm repair and abscess drainage for rapidly expanding infectious abdominal aortic aneurysm associated with psoas abscess. A 62-year-old woman who had experienced left lumboinguinal pain for 1 month was referred to our hospital. Computed tomography (CT) showed an infrarenal abdominal aortic aneurysm that was poorly marginated with psoas muscle, so she was admitted to our hospital and fully examined. We recognized an increasing inflammatory reaction after her admission, and CT showed a psoas abscess with an irregular infrarenal aortic aneurysm adjacent to it. We suspected an infectious abdominal aortic aneurysm associated with psoas abscess and initiated antibiotic therapy. Yersinia enterocolitica was detected in the psoas abscess drainage. One month after the antibiotic therapy was completed, she presented with left lumboinguinal pain again. CT showed that the aneurysm was close to rupturing, so we perfumed emergency surgery with endovascular aneurysm repair. The postoperative course was uneventful, and postoperative CT showed no endoleak of the abdominal aorta and a decreasing psoas abscess. Seven months after the surgery, CT revealed the disappearance of the aneurysm and an abscess cavity. No infection or complication has been detected during the 18 months after the surgery.