Successful Treatment for a Ruptured Solitary Tuberculous Aneurysm of the Left External Iliac Artery: A Case Report

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  • Yoshida Homare
    Department of Cardiovascular Surgery, National Hospital Organization Shikoku Medical Center for Children and Adults
  • Shimoe Yasushi
    Department of Cardiovascular Surgery, National Hospital Organization Shikoku Medical Center for Children and Adults
  • Hosoya Yuta
    Department of Cardiovascular Surgery, National Hospital Organization Shikoku Medical Center for Children and Adults
  • Okuda Naoki
    Department of Cardiovascular Surgery, National Hospital Organization Shikoku Medical Center for Children and Adults
  • Kawahito Tomohisa
    Department of Cardiovascular Surgery, National Hospital Organization Shikoku Medical Center for Children and Adults

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Other Title
  • 結核性孤立性外腸骨動脈瘤破裂の1例

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Abstract

<p>We report an extremely rare case of ruptured tuberculous external iliac artery aneurysm. A 75-year-old woman was admitted to another hospital 8 months ago for pleural inflammation and was treated with antibiotics. Mycobacterium tuberculosis was detected in the pleural fluid submitted at that time. She had been suspected of having an iliopsoas abscess by her local doctor due to left lower abdominal pain and fever for 2 weeks, and was treated with antibiotics, but the symptoms did not improve. A contrast-enhanced CT scan was performed, and a diagnosis of ruptured infected left external iliac artery aneurysm was made. Emergency laparotomy was performed, and the patient underwent aneurysmectomy, drainage, and extra-anatomical bypass with rifampicin-immersed Dacron graft. Tubercle bacilli were detected locally, and histopathological examination revealed specific tuberculous lesions on the aneurysmal wall, leading to the diagnosis of tuberculous aneurysm. The patient was discharged from the hospital on the 68th postoperative day after with anti-tuberculosis drugs. The patient continued chemotherapy for one year after surgery, and no recurrence has occurred for more than five years after an end of chemotherapy.</p>

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