INFLAMMATORY ANEURYSM OF THE BILATERAL COMMON ILIAC ARTERY -A CASE REPORT-

Abstract

Inflammatory aneurysms are common in the abdominal aorta, but uncommon in the thoracic aorta and iliac artery. Recently we experienced a rare case of inflammatory aneurysms of the bilateral iliac arteries which was diagnosed by a histopathological study. A 70-year-old man was admitted to the hospital with a 10-year history of a pulsatile mass at the right lower abdomen. Contrast enhanced CT scan of the abdomen demonstrated aneurysms of the bilateral common iliac arteries associated with a periaortic thin layer enhanced by contrast dye, and hydronephrosis of the right kidney. The aneurysms and right ureter were extremely difficult to dissect not capable of being dissected due to retroperitoneal fibrosis, even though the gross appearance of the aneurysms was not identical with that of the classical inflammatory aneurysm. Then graft replacement of the abdominal aorta to bilateral common iliac arteries was performed by using a Gelseal knitted Dacron Y graft.Pathohistological study of the aortic wall revealed heavy infiltration of lymphocytes and plasma cells in the thickened adventitial and medial layers, being compatible with an inflammatory aneurysm. This case appears to be in an extremely early stage in the spectrum of clinical pregress.