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Submitted: 17 May 2007 Modified: 27 February 2017
HERDIN Record #: PCHRD051607070556

Tuberculous pseudoaneurysm of the aortic arch: A case report .

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A 32 year old man from Nueva Ecija, Philippines was admitted to a hospital for a recurrent hemoptysis and severe chest pain. He has been having hoarseness of voice for 2 months due to paralysis of the left vocal cord. One month before the hospitalization, he started to have recurrent hemoptysis associated with chest pain radiating to the back. He was admitted to our institution for persistence of severe chest pain and massive hemoptysis. Chest radiography revealed a mass in the left paraaortic area and tuberculosis on the upper lobe of the left lung. A mass on the aorto-pulmonary window with a fistulous tract to the distal arch was noted on angiogram. The patient underwent patch graft repair of the fistulous tract opening in the aortic arch using a Dacron graft (Hemashield-Boston Scientific) under hypothermic circulatory arrest at 16 degrees Celsius. Antituberculosis pharmacotherapy was started postoperatively and maintained for a period of 6 months to one year. Tuberculous aneurysm is an extremely rare but uniformly fatal lesion if not diagnosed promptly. The English literature reports only 41 cases of tuberculous aneurysm.1 Combined medical and surgical therapies appear to offer the best chance for a cure. Close postoperative follow-up is mandatory in this group of patients.

Publication Type
Journal
Publication Sub Type
Case report
Title
The Philippine Journal of Thoracic and Cardiovascular Surgery
Frequency
Annual
Publication Date
-December 2006
Volume
13
Page(s)
33-39
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 8 Fulltext Print Format (Request Document)
1. Long, R , Guzman, R , Greenberg, H . "Tuberculous mycotic aneurysm of the aorta review of published medical and surgical experience" Chest 115, 522-531, 1999. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/10027455
2. Weigert, C . "Ueber venetuberkel und thre beziehung zur tuberculosen blutinfection" Virchows Arch Pathol Anat 88, 307-379, 1882
3. Kamen, L . "Aortenruptur auf tuberkuloser grundlage" Beitr Pathol Anat 17, 416-419, 1895
4. Haythorn, SR . "Tuberculosis of the large arteries" JAMA 60, 1413-1416, 1913. Retrieved from: http://jama.jamanetwork.com/article.aspx?articleid=214930
5. Gellerstedt, N , Safwenberg, O . "Zur kenntnis der aortatuberculose und des tubertulosen arrosionsaneurysm der aorta: upsula lakaref, forh" 38, 165-181, 1933
6. Silbergleit, A , Arbulu, A , Defever, BA , et al., . "Tuberculous aortitis" JAMA 193, 83-85, 1965
7. Parkhurst, GF , Decker, JP . "Bacterial aortitis and mycotic aneurysm of the aorta: a report of twelve cases" Am J Pathol 31, 821-835, 1955
8. Herndon, JH , Galt, J , Austin, DJ . "Ruptured tuberculous false aneurysm of the abdominal aorta" Tex State J Med 48, 336-338, 1952
9. Rob, CG , Eastcott, HH G. "Aotic aneurysm due to tuberculous lymphadenitis" BMJ 1, 378-379, 1955. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2061111/
10. Long, R , OConnor, R , Palayew, M , et al., . "Disseminated tuberculosis with and without a military pattern on chest radiograph: a clinical- pathologic- radiologic correlation" Int J Tuberc Lung Dis 1, 52-58, 1955
11. Harris, RD , Hougen, ML . "Early diagnosis of tuberculous thoracic aortic aneurysm by computerized axial tomography" J Comput Tomogr 2(2): 49-54, 1978. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/699543
12. Atlas, SW , Vogelzang, RL , Bressler, EL , Gore, RM , Bergan, JJ . "CT diagnosis of a mycotic aneurysm of the thoracoabdominal aorta" J Compt Assist Tomogr 8(6): 1211-1212, 1984. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/6548763
13. Volini, FI , Olfield Jr, RC , Thompson, JR , Kent, G . "Tuberculosis of the aorta" JAMA 181, 78-83, 1962. Retrieved from: http://jama.jamanetwork.com/article.aspx?articleid=327927
14. De Prophetic, N , Armitage, HV , Tribolettie, ED . "Rupture of tuberculous aortic aneurysm in lung" Ann Surg 150, 1046-1051, 1959. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1628999/
15. Baumgartern, EC , Cantor, MO . "Tuberculous mesarteritis with aneurysm of the femoral artery: report of a case" JAMA 100, 1918-1920, 1933. Retrieved from: http://jama.jamanetwork.com/article.aspx?articleid=243538
16. Yeoh, CB , Ford, JM , Garret, R . "Tuberculous psuedoaneurysm of descending thoracic aorta" Arch Surg 86, 318-322, 1963. Retrieved from: http://archsurg.jamanetwork.com/article.aspx?articleid=560640
17. Felson, B , Akers, PV , Hall, GS , Schrieber, JT , Greene, RE , Pedrosa, CS . "Mycotic tuberculous aneurysm of the thoracic aorta" JAMA 237, 1104-1108, 1977. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/402488
18. Quaini, E , Donatelli, F , Bonacina, E , Vitali, E , Colombo, T , Panzeri, E . "Mycotic tuberculous aneurysm of the decending thoracic aorta" Tex Heart Inst J 12, 257-266, 1985. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC341866/
19. Sandron, D , Patra, P , Lelann, P , Bouillard, J , Pioche, D . "Tuberculous pseudoaneurysm of the descending thoracic aorta" Eur Respir J 1, 565-567, 1988
20. Kline, JL , Durant, J . "Surgical resection of a tuberculosis aneurysm of the ascending aorta" N Engl J Med 265, 1185-1187, 1961
21. "Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises" Case 11-1975 292, 579-586, 1975
22. Bacourt, F , Goeau-Brissonniere, O , Lacombe, P , Parlier, H , Terestchenko, MC . "Surgical treatment of a tuberculous thoracoabdominal aneurysm" Ann Vasc Surg 1, 378-381, 1986. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/3504351