Prague Med. Rep. 2016, 117, 54-60

https://doi.org/10.14712/23362936.2016.5

Juxtarenal Mycotic Aneurysm as a Complication of Acute Exacerbation of Chronic Cholecystitis Treated by Resection and Replacement by a Fresh Allograft

Tomáš Grus1, Lukáš Lambert2, Vilém Rohn1, Tomáš Klika1, Gabriela Grusová3, Pavel Michálek4

12nd Department of Surgery – Department of Cardiovascular Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
2Department of Radiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
34th Department of Medicine – Department of Gastroenterology and Hepatology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
4Department of Anaesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic

Received August 6, 2015
Accepted February 24, 2016

We present a case of a female patient with infectious (mycotic) juxtarenal abdominal aneurysm with atypical symptoms beginning as acute exacerbation of chronic cholecystitis. Apart from common antibiotic treatment, the patient successfully underwent resection of the diseased segment and replacement by a fresh allograft in order to reduce the risk of infection of the graft, but with the need of subsequent life-long immunosuppressive therapy. Perioperative monitoring of the spinal cord by near infrared spectroscopy was used to identify possible spinal ischemia. The choice of the fresh allograft was based on our experience supported by review of the literature.

Funding

This study was supported by grants PRVOUK P27/LF1/1, NT13302-4/2012, and 15-27941A.

References

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