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Online ISSN 1827-1847
De Blasis G. 1, Bafile G. 1, D’Elia M. 1, Turco G. L. 1, Scalisi L. 1, Petitta S. 1, Passalacqua G. 2, Filauri P. 2, Pinelli M. 1, D’Amario V. 1
1 Division of Vascular Surgery SS. Filippo and Nicola Hospital, Avezzano (AQ), Italy
2 Department of Radiology SS. Filippo and Nicola Hospital, Avezzano (AQ), Italy
The purpose of the paper is to report our experience with bacterial aortitis. We discuss, also, about the pathogenesis, the diagnosis and management of such devastating pathology. We describe 3 cases of bacterial abdominal aortitis. One patient had infection by Salmonella type C, another by Salmonella typhimurium and the last by Staphylococcus aureus. The first patient was initially treated with anatomical recostruction with Dacron prosthesis because we thought that the aortic lesion was an atherosclerotic aneurysm; but, 2 months later, after gastrointestinal hemorrhage due to aorto-enteric fistula, the patient underwent endovascular treatment with endoprosthesis to stop the bleeding. Ten days later we performed a definitive recostruction with superficial femoral veins. The second patient, after temporary treatment with endoprosthesis of a ruptured aortitis, underwent surgery with recostruction utilizing superficial femoral veins. The third patient was admitted with a 3 weeks history of back pain. A multi-loculated aneurysm of the infrarenal aorta was diagnosed without signs of rupture. So we performed directly implantation of anatomical by-pass with autogenous prosthesis. Two patients are alive and without recurrent infection at 4 and 2 years of follow-up. One died for ventricular fibrillation 3 days after surgery. The results show that, like aortic graft infection, the in situ techniques with superficial femoral veins have the advantage to reduce the recurrence of infection with minimal discomfort for the patient. Temporary endovascular treatment is useful in urgent situations.