Abstract
A patient who died of rupture of a bacterial abdominal aortic aneurysm which was obstructed with thrombi is presented. A 63-year-old male patient had major complaints of abdominal pain, hyperthermia and diarrhea. By CT, ultrasonography and angiography the patient was diagnosed as having an abdominal aortic aneurysm originating from the area directly below the bifurcation of the superior measenteric artery, which was obstructed with thrombi. Although emergency laparotomy was undertaken because of the suspicion of a ruptured aneurysm, the lesion could not be excised and the patient died 3 days after the operation. The lesion was found to be a bacterial abdominal aortic aneurysm due to infection of Escherichia coli.
The possibility of a usual aneurysm being ruptured decreases markedly if the aneurysm is obstructed with thrombi. In contrast, a microbial aneurysm rarely heals spontaneously even if it is obstructed with thrombi. Under this condition the infection continues in the thrombi, resulting in rupture of the aneurysm. The histopathological examination of this patient also revealed findings showing that thrombi cannot prevent the rupture of an aneurysm in the case of a microbial aneurysm.
