INFLAMMATORY ANEURYSMS OF THE AORTA

Abstract

Inflammatory aneurysms of abdominal aorta (İAAA) Is a distinctive group among aortic aneurysms, characterized by fibrosis, adhesions to adjacent structures and cellular infiltration. Between the years 1977 to 1990, 108 AAA were operated in the Department of General Surgery of İstanbul Medical Faculty, in which 7 were specified as İAAA. All the patients were male with a mean age of 65.2; the patients were symptomatic except one, six with abdominal pain radiating back, 4 patients with a mean of 10 kg. weight loss, 4 with elevated ESR, and one patient with ureteric displacement.

Operative exploration revealed dense fibrotic adhesions between the aneurysm and duodenum, vena cava inferior. Principally dissection of the adhered structures is avoided, even avoiding the dissection of the aorta and proximal damping was carried out by compression. One patient suffered from atellectasis, and one from temporary renal failure, and there was no postoperative mortality. Our opinion is that when İAAA is considered, the operation can be carried out disregarding the aneurysm diameter. In order to eliminate operative hazards dissection of adhered structures should be abolished and aneurysm sac may be entered from a free lateral side.