Inflammatory aneurysm of the thoracoabdominal aorta with associated dissection

Rev Cardiovasc Med. 2008 Summer;9(3):204-9.

Abstract

The inflammatory variant of aortic aneurysms has 3 unique features: marked thickening of the aneurysm wall, fibrosis of the adjacent retroperitoneum, and rigid adherence of the adjacent structures to the anterior aneurysm wall. Abdominal tenderness with or without a pulsatile abdominal mass is the most common finding, although it is present in only about 33% of patients. Systemic symptoms, such as fever, malaise, and weight loss, are reported in about 20% to 50% of patients. A contrast-enhanced computed tomography scan, magnetic resonance imaging, and a transesophageal echocardiogram are among the best modalities to evaluate for inflammatory thoracoabdominal aneurysm, but a transthoracic echocardiogram can frequently be very suggestive. Medical treatment options include corticosteroids or other anti-inflammatory and immunosuppressive therapies. Surgical intervention usually consists of a transperitoneal approach with infrarenal aortic clamping. This case review describes a 64-year-old woman with a history of hypertension and dyslipidemia who presented with anemia, lower back pain, and a recent 30-pound weight loss.

Publication types

  • Case Reports

MeSH terms

  • Anemia / etiology
  • Aortic Aneurysm, Thoracic / complications
  • Aortic Aneurysm, Thoracic / pathology*
  • Aortic Aneurysm, Thoracic / surgery
  • Aortic Dissection / complications
  • Aortic Dissection / pathology*
  • Aortic Dissection / surgery
  • Blood Vessel Prosthesis Implantation
  • Dyslipidemias / complications
  • Echocardiography
  • Female
  • Humans
  • Hypertension / complications
  • Low Back Pain / etiology
  • Middle Aged
  • Radiography, Thoracic
  • Retroperitoneal Fibrosis / complications
  • Retroperitoneal Fibrosis / pathology*
  • Retroperitoneal Fibrosis / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Weight Loss