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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On occasions it may be vital to produce controlled thrombosis of an abdominal aortic aneurysm when resection is not possible. A successful technique was evolved to achieve this in a 57-year-old man with malignant lymphoma. The tumor was found to infiltrate massively the retroperitoneum and the wall of a large abdominal aortic aneurysm. The large aneurysm was deemed to be technically unresectable at operation. An approach was devised to thrombose the aneurysm and to proceed safely with chemotherapy of the malignant lymphoma. An axillobifemoral bypass was made with the limbs anastomosed end to end to the common femoral arteries. The external iliac vessels were exteriorized through the abdominal wall. The aneurysmal sac outflow was occluded by balloon catheters introduced through the exteriorized iliac vessels. A right transaxillary catheter was inserted and placed at the level of the renal arteries to induce and to control the progress of thrombus formation in such a way as to ensure patency of the renal vessels. Thrombin was delivered into the sac via this transaxillary catheter. A high urinary output was maintained. Serial angiograms of the clotting process were obtained. Once the sac was thrombosed, the balloon catheters were removed and a final angiogram was obtained which demonstrated the obliteration of the aneurysmal sac and the patency of the renal vessels. The patient has been fully employed for 20 months.
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PMID:Induced thrombosis of inoperable abdominal aortic aneurysm. 68 31

In a 61-year-old Japanese man, a concomitant bleeding gastric malignant lymphoma and expanding abdominal aortic aneurysm was evident. Bacterial studies were done for a further 32 laparotomy cases. The patient underwent abdominal aortic aneurysmectomy and partial gastrectomy simultaneously. The postoperative course was uneventful except for temporary pneumonia. The positive rate for bacterial culture in cases of gastric or colorectal cancers was significantly high compared with that in the cases of abdominal aortic aneurysm. From the viewpoint of bacterial contamination, these two operations should be done separately. However, simultaneous operations as in the current case are feasible if great care is taken.
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PMID:Successful simultaneous repair of coincidental bleeding malignant lymphoma of the stomach and expanding abdominal aortic aneurysm. 229 88

Amongst 1599 patients undergoing surgery for abdominal aortic aneurysm, there were 89 patients (5.6%) who showed typical features of inflammatory aneurysms of the abdominal aorta (IAAA). 37 of the 89 patients had been examined preoperatively by CT. In 73% of the cases (27/37) a correct diagnosis had been made. Localisation, width and extent of the IAAA was correctly diagnosed in all patients. Involvement of the renal arteries by the inflammatory process, the extent of thrombus and of mural calcification were accurately shown. The inflammatory tissues were typically ventral and lateral to the aorta. Frequently, there were adhesions to neighbouring structures. Aortic rupture, aortic dissection and retroperitoneal lymphoma may produce similar CT appearances; nevertheless, CT remains at present the method of choice for the diagnosis of IAAA because of its high sensitivity.
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PMID:[The computed tomographic diagnosis of inflammatory abdominal aortic aneurysms]. 804 62

Selecting the most appropriate surgical approach for patients with abdominal aortic aneurysm (AAA) and gastrointestinal malignancy remains controversial. In an attempt to develop guidelines for the management of patients with these two simultaneous lesions, a retrospective review of patients who had concomitant AAA and gastrointestinal malignancy was undertaken. During the period from January 1985 to February 1993, 229 patients with AAA were admitted to our hospital. Among these, 19 patients (8%) had a gastrointestinal malignancy together with AAA and were divided into 2 groups. Group I was composed of 11 patients who underwent either a 1- or a 2-stage operation for both lesions. Group II was composed of eight patients who either underwent an operation for one lesion (six patients) or did not have any operation (two patients). Among group I, six patients underwent the two-stage operation. In four of the six patients, the malignancy was resected first. In the remaining two patients, the aneurysmectomy was performed first, because, in one patient, the aneurysm was more than 6 cm in diameter, and, in the other patient, the aneurysm was a saccular type. Among group I, five patients (two patients with gastric cancer, and one patient each with esophageal cancer, rectal cancer, and malignant lymphoma of the stomach) underwent a one-stage operation. In three of the five patients (two patients with gastric cancer and one patient with esophageal cancer), simultaneous resection was carried out by using segregated approaches, namely, the retroperitoneal approach for AAA and the transperitoneal approach for malignancy. Although the clinical characteristics of the patients were different, 8 of the 11 patients (73%) in group I are still alive, whereas only 1 of the 8 patients (13%) in group II is still alive. The principles of our surgical approaches for concomitant AAA and gastrointestinal malignancy are as follows: (1) The lesion that absolutely indicated urgent surgery was resected first. (2) If both lesions were asymptomatic, the malignancy was resected first. (3) Simultaneous resection using different approaches was useful in some patients with concomitant upper early gastrointestinal malignancy. (4) Both lesions need to be resected eventually for better long-term survival.
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PMID:Management of concomitant abdominal aortic aneurysm and gastrointestinal malignancy. 835 99

Malignant lymphoma infiltrating the abdominal aorta and resulting in an aortic aneurysm has never been documented. We report here a case of angiocentric T-cell lymphoma in a 33-year-old man who for months presented intermittent fever, splenomegaly, and an abdominal pulsatile mass. Angiography revealed extensive aneurysmal dilatation of the infrarenal abdominal aorta, bilateral iliac artery, and right common femoral artery. Splenic abscess and infected abdominal aortic aneurysm were initially suspected. An urgent splenectomy and aneurysmectomy with an aortic bifemoral bypass were performed. Pathological examination of the aortic aneurysm showed extensive necrosis, severe atherosclerosis, and lymphoma cell infiltration of the aortic wall. The lymphoid cells in the aorta and spleen were stained positive for CD45RO, CD56, and CD8, but negative for CD4 and CD19. Double-labeling immunohistochemistry and in situ hybridization using EBER1 for Epstein-Barr virus (EBV) revealed positive nuclear staining in the atypical T-lymphoid cells. This is the first definitive proof of peripheral T-cell lymphoma involving the abdominal aorta. Our evidence also supports that the EBV infection of T cells could be responsible for the atherosclerosis and hypertriglyceridemia, and the angiocentricity of the tumor cells apparently results in the presenting atherosclerotic aortic wall destruction, providing an additional causative concept for abdominal aortic aneurysm.
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PMID:Epstein-Barr virus-containing T-cell lymphoma and atherosclerotic abdominal aortic aneurysm in a young adult. 1049 49

We present the case of a 60-year old woman with a ruptured thoraco-abdominal aortic aneurysm (TAAA). It was a Type IV TAAA in the Crawford Classification. A mycotic origin was suspected as she had a known history of lymphocytic lymphoma. She underwent thoraco-abdominal aortic replacement with a good surgical result. Histopathological examination revealed destruction of the aortic layers due to inflammatory lymphomatous aortic infiltration. The patient fully recovered.
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PMID:Thoraco-abdominal aortic aneurysm rupture secondary to lymphocytic lymphoma. 2765 54

Abdominal aortic aneurysm (AAA) associated with periaortic malignant lymphoma is difficult to differentiate from aneurysmal rupture because of similarities in their clinical presentation and appearance on computed tomography images. We here report a case of AAA associated with periaortic malignant lymphoma diagnosed preoperatively with an absence of typical symptoms, showing that AAA in periaortic malignant lymphoma can present without any clinical correlates. Magnetic resonance imaging was used to confirm the diagnosis. The patient was treated by endovascular repair, which may be safer and more effective than open surgery for AAA associated with malignant lymphoma because of the tight adhesion between the aneurysm and the lymphoid tissue.
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PMID:Abdominal aortic aneurysm with periaortic malignant lymphoma differentiated from aneurysmal rupture by clinical presentation and magnetic resonance imaging. 2994 90