ОСТРЫЙ ИНФЕКЦИОННЫЙ АОРТИТ С ФОРМИРОВАНИЕМ АНЕВРИЗМЫ БРЮШНОЙ АОРТЫ: КЛИНИЧЕСКИЙ СЛУЧАЙ

Abstract

Objectives. Present a clinical case and experience in managing a patient with acute infectious aortitis with the formation of an abdominal aortic aneurysm, complicated in the postoperative period by necrosis of the wall of the duodenum and jejunum. Methods. Clinical case of a rare infectious aortitis with the formation of an abdominal aortic aneurysm, complicated by necrosis of the wall of the duodenum and jejunum in postoperative period. History of the disease, the dynamics of symptoms, and the results of surgical treatment are analyzed and presented. Results. Patient G.,63 years old, presented with nonspecifi c complaints. According to the MRI results: the abdominal aorta below the renal arteries over a distance of 75 mm is aneurysmically dilated to 57-42 mm with the presence of thrombomass in the lumen and a thickened and “Ca” wall. An urgent laparotomy, revision of the abdominal organs, resection of an abdominal aortic aneurysm, and extraanatomical axillo-bifemoral bypass were performed. On the 5th day after the operation, drainage from the retroperitoneal space on the left shows discharge with a dark green tint. Relaparotomy was performed, revealing a defect in the posterior wall of the initial section of the jejunum, multiple necrosis of the posterior wall of the duodenum with perforations. Resection of the aff ected area was performed with duodenojejunostomy, unloading cholecystostomy, and NPWT application into the median wound. In the postoperative period, due to eff orts of the multidisciplinary team, multiple organ failure and infectious complications were managed.