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A Journal on Surgery

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Chirurgia 2007 August;20(4):195-7

language: English

Salmonella Endocarditis and aortic root abscess presenting as acute pancreatitis

Han L. 1, Johnkoski J. 2, Strick T. 3

1 University of Wisconsin, Wausau Family Practice Residency Program, 995 Campus Drive, Wausau, WI (USA)
2 Wausau Heart and Lung Surgeons, Aspirus Wausau Hospital, 425 Pine Ridge Boulevard, Wausau, WI (USA)
3 University of Wisconsin, Wausau Family Practice Clinic, 995 Campus Drive, Wausau, WI (USA)


Large aortic root abscess accompanied by endocarditis is uncommon but can be potentially fatal. The prevalence of salmonella infection as the offending agent in these cases is rising. Salmonella infection of the aorta is rare but associated with high mortality and morbidity. When a case presents as another entity, diagnosis can be challenging. Surgical repair is the treatment of choice and superior to any other measures.  However surgical mortality of prosthetic valve replacement in the treatment of endocarditis is high, and is highest among patients with aortic root abscess, both intraoperatively and postoperatively. The success of the treatment of complex aortic root abscess with a prosthetic valve depends upon early diagnosis, clear anatomical definition preoperatively, appropriate surgical debridement, homograft aortic root reconstruction, and antibiotic treatment to maintain sterility of the implant. Despite all current advances in diagnosis, more potent antibiotics, and improvements in surgical techniques, the mortality of salmonella vascular infection remains high. We reported a case with salmonella endocarditis and a large aortic root abscess, which presented as an acute pancreatitis in a 39-year-old male. The process was complicated, but the outcome was excellent. In this article we also review the literature on this subject in the past two decades.

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