Abstract
A case of ruptured infected thoracoabdominal aortic aneurysm (TAAA) was successfully managed with emergency resection with reconstruction in infected field.
A 76-year-old man was admitted to the hospital because of a painful pulsatile mass in the upper abdomen. A diganosis of ruptuted infected TAAA was made based on abdominal CT scanning, angiography and marked inflammation. An emergency operation was performed. A saccular aneurysm about 3cm in diameter was present and involved the orifices of the celiac axis. No gross accumlation of pus was found. The retroperitoneal phlegmon and aortic wall were debrided as extensive as possible. Since allowance was made for surgical stress and for the age of the patient, visceral artery replacement with prosthetic graft orthotopically and extraanatomic reconstruction of the aorta were performed. Staphylococus aureus was isolated from a culture of the aortic wall. Intensive antibiotic therapy was started postoperatively. The patient was discharged about three months afte the operation. There has been no sign of recurrent infection.
