Inflammatory aneurysms of the abdominal aorta
H. H. Moosa, A. B. Peitzman, D. L. Steed, T. B. Julian, F. Jarrett and M. W. Webster
Department of Surgery, University of Pittsburgh School of Medicine, PA.
Inflammatory aneurysms of the abdominal aorta (IAAAs) have distinctive
clinical and physical characteristics that separate them from typical
atherosclerotic aneurysms. They were identified in 19 (7.2%) of 265
patients undergoing abdominal aortic aneurysm repair. Symptoms were present
in 12 (63%) of 19, with one patient presenting with rupture, and multiple
symptoms were present in six (32%). Intraoperatively, all aneurysms
exhibited dense periaortic inflammation. Adjacent structures most
frequently involved were the duodenum in 15 (79%) of 19 patients, the left
renal vein in six (32%) of 19, and the ureter in five (26%) of 19.
Seventeen (94%) of the 18 patients who underwent elective aneurysm
resection survived. The involvement of retroperitoneal structures varied in
number and severity, demonstrating that a wide spectrum of inflammation is
present in IAAAs, making diagnosis and definition difficult.
