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• W2100085223 abstract "A 51-year-old man was admitted urgently with a 3 week history of back pain. Clinical examination revealed a tender abdomen and a temperature of 39 8C. There was a leucocytosis of 15 900. An abdominal CT scan was immediately performed and this confirmed the presence of a saccular abdominal aortic aneurysm. Because of the presence of retroperitoneal extravasation and a probable rupture, a laparotomy was performed. During para-aortic dissection a large abscess arising from the back of the aorta was found. There was a 25 mm perforation of the aorta which extended up to the left renal artery (Fig. 1). The aorta was resected obliquely above the abscess, preserving the right renal artery. The left renal artery had to be ligated. After debridement the surgical area was filled with omentum. In order to restore the blood circulation distally, we implanted a 6 mm PTFE axillobifemoral bypass. A microbiological swab taken during the procedure grew salmonella enteritidis. About three weeks later the patient suddenly developed acute abdominal pain. A CT scan showed and extended septic aneurysm which had developed around the aortic stump although the patient was on continuous treatment with metronidazole and a cephalosporin. Subsequent surgical revision revealed an infected 10 cm £ 10 cm pulsatile aneurysm surrounding the site of resection of the aorta (Fig. 1). During the following operation the aorta was resected above the celiac trunk and the visceral circulation was restored through an aorto-coeliac bypass using saphenous vein. The right renal blood supply was reestablished through a saphenous vein interposition between the right renal artery and the aorta (Fig. 2). The aneurysm cavity was opened and drained. A further laparotomy performed two days later in order to assess the blood supply of the gastrointestinal tract was satisfactory. After 65 days of ICU treatment complicated because of a protracted pseudomonas pneumonia and 93 days of hospitalisation the patient was discharge home. Antibiotic therapy was stopped three weeks after discharge. Five months later the patient was admitted as an emergency and operated on for disseminated peritonitis caused by multiple small ischaemia-induced perforations in the ascending colon. An intraoperative swab grew the same serotype of salmonella enteritidis as before, and an endogenous reinfection was diagnosed. A right hemicolectomy was performed and because of the poor intestinal blood supply, an EJVES Extra 5, 92–94 (2003) doi: 10.1016/S1533-3167(03)00030-X, available online at http://www.sciencedirect.com on" @default.
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• W2100085223 date "2003-06-01" @default.
• W2100085223 modified "2023-10-18" @default.
• W2100085223 title "Aortic Rupture due to Salmonella Infection—Surgical Reconstructive Options" @default.
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• W2100085223 doi "https://doi.org/10.1016/s1533-3167(03)00030-x" @default.
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