Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature review

Emphysematous aortitis is a rare but serious clinical form of infectious aortitis that can lead to potentially fatal complications, in particular pseudoaneurysms of the aorta that rapidly progress to rupture. This article describes the case of a 61-year-old man who presented with severe abdominal pa...

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Main Authors: Tarik Bakkali, Safaa Mouhanni, Jalal Kherroubi, Saad Alyakine, Mehdi Lekehal, Ayoub Bounssir, Brahim Lekehal
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S193004332500278X
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author Tarik Bakkali
Safaa Mouhanni
Jalal Kherroubi
Saad Alyakine
Mehdi Lekehal
Ayoub Bounssir
Brahim Lekehal
author_facet Tarik Bakkali
Safaa Mouhanni
Jalal Kherroubi
Saad Alyakine
Mehdi Lekehal
Ayoub Bounssir
Brahim Lekehal
author_sort Tarik Bakkali
collection DOAJ
description Emphysematous aortitis is a rare but serious clinical form of infectious aortitis that can lead to potentially fatal complications, in particular pseudoaneurysms of the aorta that rapidly progress to rupture. This article describes the case of a 61-year-old man who presented with severe abdominal pain of 10 days duration associated with a hypertensive crisis. Imaging revealed emphysematous aortitis complicated by an abdominal aortic pseudoaneurysm measuring 14 × 11 mm surrounded by periaortic inflammation and intramural gas. Despite early probabilistic antibiotic therapy, angio-CT surveillance revealed rapid growth of the pseudoaneurysm to 28 × 24 mm within 48 hours. Emergency surgical treatment with an aortic allograft was performed, and postoperative cultures identified Salmonella species as the pathogen. This case highlights the importance of imaging, particularly angioscan, in establishing the diagnosis, assessing the severity of this disease and the importance of prompt surgery in the management of this highly aggressive condition. A review of similar cases in the literature is included to contextualize this rare clinical entity.
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institution Kabale University
issn 1930-0433
language English
publishDate 2025-07-01
publisher Elsevier
record_format Article
series Radiology Case Reports
spelling doaj-art-2ce8120f58ca4bb595e802060fec3ae92025-08-20T03:49:42ZengElsevierRadiology Case Reports1930-04332025-07-012073380338310.1016/j.radcr.2025.03.068Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature reviewTarik Bakkali0Safaa Mouhanni1Jalal Kherroubi2Saad Alyakine3Mehdi Lekehal4Ayoub Bounssir5Brahim Lekehal6Mohammed V University in Rabat, Rabat, Morocco; Vascular Surgery Department, Ibn Sina University Hospital Centre, Rabat, MoroccoAbdelmalek-Essaadi University, Tétouan, Morocco; Service de chirurgie vasculaire, CHU de Mohammed VI, Tanger, Morocco; Corresponding author.Mohammed V University in Rabat, Rabat, Morocco; Vascular Surgery Department, Ibn Sina University Hospital Centre, Rabat, MoroccoMohammed V University in Rabat, Rabat, Morocco; Vascular Surgery Department, Ibn Sina University Hospital Centre, Rabat, MoroccoMohammed V University in Rabat, Rabat, Morocco; Vascular Surgery Department, Ibn Sina University Hospital Centre, Rabat, MoroccoMohammed V University in Rabat, Rabat, Morocco; Vascular Surgery Department, Ibn Sina University Hospital Centre, Rabat, MoroccoMohammed V University in Rabat, Rabat, Morocco; Vascular Surgery Department, Ibn Sina University Hospital Centre, Rabat, MoroccoEmphysematous aortitis is a rare but serious clinical form of infectious aortitis that can lead to potentially fatal complications, in particular pseudoaneurysms of the aorta that rapidly progress to rupture. This article describes the case of a 61-year-old man who presented with severe abdominal pain of 10 days duration associated with a hypertensive crisis. Imaging revealed emphysematous aortitis complicated by an abdominal aortic pseudoaneurysm measuring 14 × 11 mm surrounded by periaortic inflammation and intramural gas. Despite early probabilistic antibiotic therapy, angio-CT surveillance revealed rapid growth of the pseudoaneurysm to 28 × 24 mm within 48 hours. Emergency surgical treatment with an aortic allograft was performed, and postoperative cultures identified Salmonella species as the pathogen. This case highlights the importance of imaging, particularly angioscan, in establishing the diagnosis, assessing the severity of this disease and the importance of prompt surgery in the management of this highly aggressive condition. A review of similar cases in the literature is included to contextualize this rare clinical entity.http://www.sciencedirect.com/science/article/pii/S193004332500278XSalmonellaPseudoaneurysmAortaAntibiotic
spellingShingle Tarik Bakkali
Safaa Mouhanni
Jalal Kherroubi
Saad Alyakine
Mehdi Lekehal
Ayoub Bounssir
Brahim Lekehal
Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature review
Radiology Case Reports
Salmonella
Pseudoaneurysm
Aorta
Antibiotic
title Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature review
title_full Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature review
title_fullStr Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature review
title_full_unstemmed Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature review
title_short Emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta, a life-threatening emergency: Case report and literature review
title_sort emphysematous aortitis complicated by a rapidly evolving pseudoaneurysm of the abdominal aorta a life threatening emergency case report and literature review
topic Salmonella
Pseudoaneurysm
Aorta
Antibiotic
url http://www.sciencedirect.com/science/article/pii/S193004332500278X
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