Multiple Mycotic Visceral Artery Aneurysms

European Journal of Vascular and Endovascular Surgery, 1995

Journal of vascular surgery, 2016

Visceral artery aneurysms as a result of arterial degenerative disease are rare (0.1%-2%), and the superior mesenteric artery (SMA) accounts for 3.2% of all reported series. The current incidence of inferior mesenteric artery (IMA) aneurysm is unknown. However, infective causes (mycotic) of SMA and IMA aneurysm as a result of primary, secondary, and cryptogenic etiology remain a separate entity and attain fewer cases in the literature. Currently, there is no consensus on their presentation, diagnosis, and overall management. A systematic review and meta-aggregation of literature from 1944 to March 2015 in the English language and of adult subjects in MEDLINE, Ovid, CINAHL, and the Cochrane database was conducted. The median age of patients with SMA aneurysm was 36 (range, 14-92) years, with a significant male predominance (73% vs 27%). In order of prevalence, abdominal pain (n = 25; 65%), low-grade fever (n = 23; 60%), malaise (n = 10; 26%), weight loss (n = 9; 23%), and nausea and ...

Current Infectious Disease Reports, 2009

We reviewed all papers most recently reported in the literature related to infected arterial aneurysms (IAAs) affecting the aorta and vascular beds other than the aorta. In this article, we report on vascular beds other than the aorta. As is the case for aortic IAAs, infected non-aortic aneurysms are rarely encountered. The majority of recent studies are limited to case reports and small series of unusual infected aneurysms. A comprehensive review of this entity was performed based on the available literature from January through December 2008 in all languages. Available reports were analyzed with respect to demographic features, type of presentation, methods of diagnosis and therapy, follow-up, and outcome (morbidity and mortality).

Indian Journal of Vascular and Endovascular Surgery, 2015

In this article the terminology used to describe venous dilatations were: 1) phlebectasia or venomegalia defined as a diffuse dilatation of one or more veins with a caliber increase ≥ 50% compared with normal [8,9] 2) primary venous aneurysm is defined as a solitary area of venous dilatation that is ≥ 1.5 times the diameter of the normal proximal and distal vein size [10,11], that containing all 3 layers of the vein wall that communicates with a main venous structure by a single channel and must have no association with an arteriovenous communication or pseudoaneurysm, nor be related to a varicose vein (chronic venous insufficiency) [12]. We just included patients that met the required criteria to classify her venous pathology as a primary venous aneurysm and we reviewed hospital records for patient's demographic characteristics, clinical presentation, diagnosis approach, treatment and evolution.

Clinical Imaging, 2009

A 62-year-old male with multiple medical problems including a long-standing history of muscular dystrophy presented with recurrent abdominal and back pain of 2-month duration. Two consecutive mesenteric arteriograms were performed 3 weeks apart as part of the workup and treatment. The latest study revealed a significant progression in the size and number of visceral artery aneurysms. No association between the patient's muscular dystrophy and rapid development of these aneurysms has been previously reported. The patient's overall health and vascular anatomy prohibited any therapeutic intervention. This case represents the highest number of visceral artery aneurysms (13 in total) reported in a single patient.

European Journal of Vascular and Endovascular Surgery, 2010

Objective: To review our management of mycotic aneurysms involving the abdominal aorta over the past 2 decades to assess the safety and efficacy of in-situ and extraanatomic repair combined with antibiotic treatment. Materials and methods: From March 1990 to August 2008, 44 patients with a mycotic aneurysm involving the abdominal aorta were treated at our University Hospital. For all patients, we recorded the aetiology, clinical findings and anatomic location of the aneurysm, as well as bacteriology results, surgical and antibiotic therapy and morbidity and mortality. Results: Twenty-one (47.7%) of the mycotic aneurysms had already ruptured at the time of surgery. Free rupture was present in nine patients (20.5%). Contained rupture was observed in 12 patients (27.3%).

The Turkish journal of pediatrics

Multiple visceral microaneurysms of mycotic origin are very uncommon. We present an 11-year-old child with the clinical and biochemical signs of septicemia in whom arteriographic study revealed multiple microaneurysms of renal, hepatic, gastroduodenal, ileocolic and right colic arteries. Six weeks of antibacterial treatment resulted in resolution of the septicemia and most of the aneurysms healed without the need for endovascular or surgical treatment.

Journal of Ultrasonography, 2018

Although visceral artery aneurysms are rare, mortality due to their rupture is high, estimated at even 25-75%. That is why it is significant to detect each such lesion. Visceral artery aneurysms are usually asymptomatic and found incidentally during examinations performed for other indications. Autopsy results suggest that most asymptomatic aneurysms remain undiagnosed during lifetime. Their prevalence in the population is therefore higher. The manifestation of a ruptured aneurysm depends on its location and may involve intraperitoneal hemorrhage, gastrointestinal and portal system bleeding with concomitant portal hypertension and bleeding from esophageal varices. Wide access to diagnostic tests, for example ultrasound, computed tomography or magnetic resonance imaging, helps establish the correct diagnosis and a therapeutic plan as well as select appropriate treatment. After a procedure, the same diagnostic tools enable assessment of treatment efficacy, or are used for the monitoring of aneurysm size and detection of potential complications in cases that are ineligible for treatment. The type of treatment depends on the size of an aneurysm, the course of the disease, risk of rupture and risk associated with surgery or endovascular procedure. Endovascular treatment is preferred in most cases. Aneurysms are excluded from the circulation using embolization coils, ethylene vinyl alcohol, stents, multilayer stents, stent grafts and histoacryl glue (or a combination of these methods).

AORTA, 2013

Infected aneurysm (or mycotic aneurysm) is defined as an infectious disease of the wall of an artery with formation of a blind, saccular out-pouching that is contiguous with the arterial lumen. Symptoms are frequently absent or nonspecific during the early stages. Once clinically presented, infected aneurysms are often at an advanced stage of development and associated with complications such as rupture. Nontreatment or delayed treatment of infected aneurysms has a poor outcome, with high morbidity and mortality rate via fulminant sepsis or hemorrhage. In clinically suspected cases, computed tomography is used for diagnosis. Urgent surgery, performed to prevent aortic rupture carries high morbidity and mortality rates.

Surgical neurology international, 2017

Mycotic aneurysm is a rare potentially life-threatening complication of infective endocarditis (IE). Little data is available on the management and outcomes of ruptured mycotic aneurysms with large intracerebral hematoma. Few cases have been described on the management of mycotic aneurysm in the presence of life-threatening hematoma and mass effect. We are presenting two cases of ruptured mycotic aneurysm with intracerebral hematoma and impending brain herniation. Both patients had signs of high intracranial pressure and required urgent surgical evacuation of clot. One patient survived while the other patient expired soon after surgery. Mycotic aneurysm of middle cerebral artery (MCA) in IE with intracranial hemorrhage is rare and urgent surgical decompression, and aneurysmal clipping can be lifesaving.