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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/3371

 
Title :[症例報告]Staged surgical management of abdominal aortic aneurysm with Klebsiella pneumoniae infection : A case report
Authors :Kusaba, Akira
Koja, Kageharu
Sunagawa, Kazuya
Kamada, Yoshihiko
Kuda, Tomoharu
Sakuda, Hitosi
Tamaki, Masato
Tamashiro, Mamoru
Matsubara, Shinobu
Nakao, Kiyoshi
Authors affiliation :Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
Division of Surgery, Yonabaru Chuo Hospital, Okinawa, Japan
Issue Date :1997
Publisher :琉球医学会
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :1346888X
0289-1530
Abstract :A 65-year-old Japanese man with an infected saccular aneurysm in the terminal abdominal aorta and septicemia with a high fever over 41℃ related to a liver abscess was successfully treated by an initial aneurysmectomy with axillo-bifemoral prosthetic bypass and by a secondary anatomical aorto-bifemoral prosthetic bypass. A preoperative blood culture grew Klebsiella pneumoniae. An abdominal CT scan and aortography revealed a protrusive saccular aneurysm in the terminal abdominal aorta, associated with compressive thrombosis of the inferior vena cava (IVC) and left common iliac vein. Aneurysmectomy with thorough debridement of the retroperitoneal tissues was initially performed. The aortic stump was oversewn and arterial circulation was restored to the bilateral lower extremities by an axillo-bifemoral prosthetic bypass graft. The occluded ilio-caval venous trunk was reconstructed simultaneously by thrombectomy. After continuous oral administration of antibiotic for 5 months, the arterial continuity was secondarily reverted in the anatomical route using an aorto-bifemoral prosthetic bypass. Thus, we are able to recommend staged surgical management of infected abdominal aortic aneurysms for the prevention of postoperative graft infection and delayed blowout of the sewn aortic stump.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/3371
Citation :琉球医学会誌 = Ryukyu Medical Journal Vol.17 no.2 p.105 -108
Appears in Collections:Ryukyu Medical Journal

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