Repair of Salmonella mycotic aneurysm of the paravisceral abdominal aorta using in situ prosthetic graft

Abstract

Salmonella infection of the abdominal aorta is associated with a high mortality and morbidity, especially when the paravisceral segment is involved. The presentation may be vague and a high index of suspicion is required in order to make the diagnosis early so that prompt treatment can be instituted. Imaging techniques such as computed tomography and angiogram are useful in arriving at a diagnosis as well as planning of operation. The management of a patient with Salmonella mycotic aortic aneurysm includes potent antibiotics, adequate debridement and revascularization. The method of revascularization, in situ bypass or extra-anatomic bypass, has been the subject of controversy. In situ bypass involves placing a graft in an infected field with potentially fatal graft infection, while extra-anatomic bypass has the problem of inferior patency and the necessity of a future reconstruction. We report here a patient with Salmonella mycotic aneurysm of the paravisceral abdominal aorta successfully treated with in situ prosthetic bypass graft.