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Online ISSN 1827-1847
Bajardi G., Talarico F., Ricevuto G., Calì F.
From the Department of Vascular Surgery University of Palermo
Background. The aim of this study was to report our experience of a pathology that is diagnosed with increasing frequency: inflammatory aneurysms of the abdominal aorta (IAAA).
Methods. We report our experience of 5 cases observed during between November 1999 and November 2000 (10% of all AAA observed during the same period). Two patients were underwent emergency surgery following IAAA rupture. All patients underwent ECO (in election) and CAT with contrast medium. A preoperative diagnosis of IAAA was made in 3 out of 5 cases (60%). Left hydroureteronephrosis was present in 1 case (20%). All patients underwent surgery using transperitoneal access.
Results. Postoperative mortality was zero. The main complication was 1 case (20%) of pancreatitis which regressed with medical treatment. Cortisone treatment was associated in all cases for 2 months.
Conclusions. The pathogenetic mechanisms of IAAA are discussed. The implications of surgical treatment are analysed (transperitoneal vs retroperitoneal access), (endovascular treatment vs open surgery) (opportunity for surgical procedures involving other organs). The study underlines the importance of preoperative diagnosis as a means of planning all the phases of treatment (treatment of IAAA, provoke of retroperitoneal fibrosis (FR), antiphlogistic treatment). Although IAAA provoke an increase in postoperative morbidity and mortality, a careful surgical preparation with minimal dissection and remote clamping represents the best prophylaxis of complications. IAAA require scrupulous follow-up in order to monitor the evolution of FR and regulate any associated medical treatment required.
language: English, Italian