A 57-year-old male ex-smoker, whose personal history included hypertension treated with angiotensin II receptor antagonists, mental illness and hyperuricemia treated with Zyloric®.
She has not been operated previously.
The history of the process begins with a back pain and recurrent urinary infections, which is why the patient comes to his primary care physician. An ultrasound is performed to check for an abdominal aortic aneurysm of about 5 cm in diameter.
The patient was referred to the vascular surgery outpatient clinic of our hospital.
The general physical examination was normal except for the detection of a large abdominal pulsatile mass at the periumbilical level.
In both lower limbs pulses are beaten bilaterally at all levels and symmetrical beats are appreciated at the level of the carotid arteries, without hearing murmurs.
At this time, we requested a computed angiotomography (angioCT), which confirmed the presence of an inflammatory infrarenal abdominal aortic aneurysm of 6.2 × 6.2 cm in diameter.
There was no evidence of extension of the aneurysm to the common iliac arteries.
Both kidneys and excretory systems were normal.
After this confirmation, a preoperative routine study was performed, consisting of normal laboratory tests (C3 and C4, CRP 1.78), chest X-ray, electrocardiogram, echocardiogram and respiratory function tests, all within normal limits.
With the prior informed consent of the patient, the surgical procedure was performed by retroperitoneal approach through lumbotomy.
The clamping was infrarenal and the treatment consisted of replacement of the affected segment by a fistula mass by placement of a left thematic prosthesis of the inflammatory type 16 mm adherneurosis. Intraoperatively, it was found an inflammatory reaction.
In addition, enlarged lymph nodes were found and resected for anatomopathological study. Subsequently, they were informed as inflammatory tissue with lymphoid characteristics.
The aortic lumen was white, with no thrombus inside.
During the post-operative period, the patient presented a clinically stable condition with good evolution of the surgical wounds; only required transfusion of three units of concentrated hemoglobin due to a decrease in hemoglobin.
At discharge, laboratory values were within normal limits.
