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Salmonella enteritidis abdominal aorta mycotic aneurysm presented with acute cholestatic jaundice: A case report and literature review

Wahab AA, Mohamed N, Ding CH, Muttaqillah NAS, Rosli N, Mohammed F

Trop Biomed, 2023 Mar 01;40(1):23-28.
PMID: 37356000 DOI: 10.47665/tb.40.1.008

Mycotic aneurysm is one of the extra-intestinal manifestations of Salmonella Enteritidis infection. The diagnosis of this condition is challenging owed to its variation in clinical presentations. We presented a case of a 54-year-old man with underlying diabetes mellitus and chronic smokers presented with acute right flank pain and fever associated with mild jaundice. The initial laboratory investigations suggested features of obstructive jaundice and urinary tract infection. The contrast enhancing computed tomography of the abdomen revealed the presence of saccular mycotic aneurysm located at the infrarenal abdominal aorta. The blood culture grew Salmonella Enteritidis which was susceptible to ceftriaxone, trimethoprim-sulfamethoxazole, ciprofloxacin, ampicillin, and amoxicillin-clavulanic acid. Intravenous ceftriaxone was initiated, and he underwent open surgery and artery repair at day 8 of admission. He responded well to the treatment given and subsequently discharged home after completed three weeks of intravenous ceftriaxone.

Matched MeSH terms: Aorta, Abdominal/surgery
Fulltext Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index: a new approach of assessing hypovolemic shock class 1

Rahman NH, Ahmad R, Kareem MM, Mohammed MI

Int J Emerg Med, 2016 Dec;9(1):8.
PMID: 26894896 DOI: 10.1186/s12245-016-0101-z

We designed this study to expand the usage of ultrasound to detect early occurrence of hypovolemia. We explore the potential use of inferior vena cava (IVC) and abdominal aorta (AA) diameter index (IVC:AA) measured ultrasonographically to detect class 1 hypovolemic shock with blood loss less than 15%.ᅟ

Matched MeSH terms: Aorta, Abdominal
Fulltext Fluorescence multispectral imaging-based diagnostic system for atherosclerosis

Ho CS, Horiuchi T, Taniguchi H, Umetsu A, Hagisawa K, Iwaya K, et al.

Biomed Eng Online, 2016 Aug 20;15(1):98.
PMID: 27542354 DOI: 10.1186/s12938-016-0220-z

Composition of atherosclerotic arterial walls is rich in lipids such as cholesterol, unlike normal arterial walls. In this study, we aimed to utilize this difference to diagnose atherosclerosis via multispectral fluorescence imaging, which allows for identification of fluorescence originating from the substance in the arterial wall.

Matched MeSH terms: Aorta, Abdominal/pathology
Fulltext Review of abdominal aortic aneurysms at the University Hospital, Kuala Lumpur

Yeoh NTL, Lim KH

Med J Malaysia, 1982 Sep;37(3):245-8.
PMID: 7177006
Matched MeSH terms: Aorta, Abdominal
Rare variations in the Origin, Branching Pattern and Course of the Celiac Trunk: Report of Two Cases

Prasanna LC, Alva R, Sneha GK, Bhat KM

Malays J Med Sci, 2016 Jan;23(1):77-81.
PMID: 27540329

Multiple anomalies in the celiac arterial system presents as rare vascular malformations, depicting deviations of the normal vascular developmental pattern. We found a common left gastro-phrenic trunk and a hepato-spleno-mesenteric trunk arising separately from the abdominal aorta in one cadaver. We also found a common hepatic artery and a gastro-splenic trunk arising individually from the abdominal aorta in another cadaver. Even though many variations in the celiac trunk have been described earlier, the complex variations described here are not mentioned and classified by earlier literature. Knowledge of such variations has significance in the surgical and invasive arterial radiological procedures in the upper abdomen.

Matched MeSH terms: Aorta, Abdominal
Fulltext Spontaneous internal ilio-iliac fistula in an elderly woman presenting as heart failure

Tan G, Abdullah B, Kunanayagam S

Biomed Imaging Interv J, 2006 Apr;2(2):e13.
PMID: 21614225 MyJurnal DOI: 10.2349/biij.2.2.e13

Acquired intra-abdominal arteriovenous fistulas (AVFs) are a rare disorder where the communication most commonly occurs between abdominal aorta and inferior vena cava. Ilio-iliac AVF has been reported previously, but is exceedingly rare. We present a case of spontaneous ilio-iliac AVF in an elderly woman who presented with symptoms of right heart failure where the diagnosis was not considered. The computed tomographic (CT) and angiographic features are described. The current status of management as well as a review of the literature is also presented.

Matched MeSH terms: Aorta, Abdominal
Fulltext Fluid structure interaction of renal arteries of abdominal aorta subjected to single and double stenosed complication

Adi Azriff Basri, S.M Abdul Khader, Cherian Johny, Raghuvir Pai B, Mohammed Zuber, Zainuldin Ahmad, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(108):35-41.
MyJurnal

Introduction: In this study, Renal artery (RA) stenosis of Single Stenosed (SS) and Double Stenosed (DS) with the condition of Normal Blood Pressure (NBP) and High Blood Pressure (HBP) were investigated using the aid of Fluid Structure Interaction (FSI) approach. Methods: Numerical analysis of 3D model patient’s specific abdominal aorta with RA stenosis was conducted using FSI solver in software ANSYS 18. Results: The results of velocity profile, pres- sure drop, time average wall shear stress (TAWSS), Oscillatory shear index (OSI) and total deformation of SS and DS with the condition of NBP and HBP were compared in terms of blood flow and structural wall tissue behaviour. The results concluded SS-NBP produced the highest value of velocity profile, TAWSS and OSI parameter compared to the others. Meanwhile, SS-HBP indicates the highest value pressure drop. On the other hand, SS-HBP and DS-HBP have a higher distribution of deformation contour and also maximum VMS compared to SS-NBP and DS-HBP. Conclusion: With the aid of FSI approach, this studied has proven that the existence of SS at RA location has a higher impact on the velocity magnitude, higher pressure drop, higher TAWSS and OSI value compared to the DS case. This is due to a high concentration of pressure acting at the narrow blood vessel of SS compared to DS cases which most of the blood flow will pass to the lower part of abdominal aorta.

Matched MeSH terms: Aorta, Abdominal
Fulltext Pseudoaneurysm Of External Iliac Artery Following Septic Loosening Of Total Hip Arthroplasty

Rengsen, P., Abbas, A.A., Choon, S.K., Tai, C.C.

Malays Orthop J, 2007;1(1):42-43.
MyJurnal

The incidence of pseudoaneurysm after total hip arthroplasty is extremely rare. The most common mechanism of vascular injury is due to direct trauma during the operative procedure and most reported cases are acute in a presentation. We report an unusual case of pseudoaneurysm of the external iliac artery, presenting 6 years after initial surgery, and occurring following septic loosening of total hip arthroplasty. This case highlights the importance of prompt recognition of infection of total hip arthroplasty, and also indicates the need for prompt and appropriate treatment for these infections.

Matched MeSH terms: Aorta, Abdominal
Fulltext A case of metastatic adenocarcinoma from an unknown primary involving the aortic bifurcation

Safri LS, Md Noh MSF, Hariz Ramli AR, Md Pauzi SH, Md Idris MA, Harunarashid H

J Vasc Surg Cases Innov Tech, 2018 Jun;4(2):160-162.
PMID: 29942910 DOI: 10.1016/j.jvscit.2018.03.004

Aortic malignant neoplasms are rare; these may be primary or secondary (metastatic). Increasing use of cross-sectional imaging has allowed better detection and diagnosis of these conditions. We encountered a young woman presenting with acute abdomen who was found on cross-sectional imaging to have a malignant tumor involving the aortic bifurcation. An en bloc excision of the tumor was performed, with distal aorta reconstruction using an aortoiliac Dacron graft; this was complicated with infection and graft occlusion, necessitating total removal and extra-anatomic bypass. A pathologic diagnosis of metastatic adenocarcinoma involving the aortic bifurcation, with an unknown primary, was made.

Matched MeSH terms: Aorta, Abdominal
Urogenital Vascular Anomalies with Bilateral Kinking of Ureter: A Case Report

Tadipi S, Sadashiv R, Muralidharan S, Pimid M

Malays J Med Sci, 2015 Nov;22(6):67-70.
PMID: 28223889

Variations in the urogenital vascular anomalies in the abdomen are very common. However, they warrant attention due to their importance in operative, diagnostic, and endovascular procedures. During routine dissection of abdomen in a male cadaver, unique urogenital vascular anomalies were observed. On the right side, the right renal artery was found to be originated from the abdominal aorta at the level of L2 and divided into five branches; the right testicular artery and inferior suprarenal artery originated from the lower branch. We also observed, accessory renal artery arising from abdominal aorta at the level of L3 and double renal veins on right side. On the left side, we found left renal artery originating from the abdominal aorta at the level of L2 and divided into two branches. Double testicular (medial and lateral) arteries were also observed. In addition to these vascular variations, bilateral kinking of ureter at the pelviureteric junction was also observed. Although the variations in the origin of urogenital vessels in the abdomen are common, deeper understanding of the urogenital vascular variations and their relations to adjacent structures is significant during surgical and radiological procedures.

Matched MeSH terms: Aorta, Abdominal
Fulltext Abdominal aorta and inferior vena cava thromboses in advanced stage of malignant fibrous histiocytoma

Faisham WI, Zulmi W, Ezane AM, Biswal BM

Med J Malaysia, 2005 Oct;60(4):495-7.
PMID: 16570715

Asymptomatic simultaneous thrombosis of abdominal aorta and inferior vena cava is a rare complication in advanced malignancy. We described an incidental finding of this clinical entity in our patient who presented with advance stage of malignant fibrous hystiocytoma of soft tissue and pathological fracture. The radiological evaluation with spiral computed tomography scan of abdominal aorta and inferior vena cava are presented and the subsequent management highlighted.

Matched MeSH terms: Aorta, Abdominal/physiopathology*
Risk factors associated with umbilical vascular catheter-associated thrombosis in newborn infants

Boo NY, Wong NC, Zulkifli SS, Lye MS

J Paediatr Child Health, 1999 Oct;35(5):460-5.
PMID: 10571759

OBJECTIVE: To determine the risk factors associated with umbilical vascular catheter-associated thrombosis.
METHODS: All consecutive inborn infants with umbilical arterial (UAC) and/or umbilical venous catheters (UVC) inserted for more than 6 h duration were included in the study. Each infant was screened for thrombosis in the abdominal aorta and inferior vena cava by 2-D abdominal ultrasonography within 48-72 h of insertion of umbilical vascular catheters. Subsequent serial scanning was performed at intervals of every 5-7 days, and within 48 h after removal of catheters.
RESULTS: Upon removal of umbilical catheters, abdominal aortic thrombi were detected in 32/99 (32.3%) infants with UAC. Small thrombi were detected in the inferior vena cava of 2/49 (4.1%) infants with UVC (one of whom had both UAC and UVC). When compared with those who received only UVC (n = 18), infants who received either UAC alone (n = 68) or both UAC and UVC (n = 31) had significantly higher risk of developing thrombosis (odds ratio (OR): 7.6, 95% confidence interval (CI): 1.1, 325.5)). Logistic regression analysis of various potential risk factors showed that the only significant risk factor associated with the development of abdominal aortic thrombosis following insertion of UAC was longer duration of UAC in situ (for every additional day of UAC in situ, adjusted OR of developing thrombosis was: 1.2, 95% CI: 1.1, 1.3; P = 0.002).
CONCLUSION: Umbilical arterial catheter-associated thrombosis was common. Umbilical arterial catheter should be removed as soon as possible when not needed. Upon removal of UAC, all infants should be screened for abdominal aortic thrombus by 2-D ultrasonography.

Matched MeSH terms: Aorta, Abdominal/pathology*
Effect of implantation site on outcome of tissue-engineered vascular grafts

Sologashvili T, Saat SA, Tille JC, De Valence S, Mugnai D, Giliberto JP, et al.

Eur J Pharm Biopharm, 2019 Jun;139:272-278.
PMID: 31004790 DOI: 10.1016/j.ejpb.2019.04.012

OBJECTIVE: Vascular prostheses for small caliber bypass grafts in cardiac and vascular diseases or for access surgery are still missing. Poly (Ɛ-caprolactone) (PCL) has been previously investigated by our group and showed good biocompatibility and mechanical properties in vitro and rapid endothelialisation, cellular infiltration and vascularisation in vivo yielding optimal patency in the abdominal aortic position. The aim of the present study is to evaluate our PCL graft in the carotid position and to compare its outcome to the grafts implanted in the abdominal aortic position.
METHODS: PCL grafts (1 mm ID/10 mm long) were implanted into the left common carotid artery in 20 Sprague-Dawley rats and compared to our previously published series of abdominal aortic implants. The animals were followed up to 3, 6, 12 and 24 weeks. At each time point, in vivo compliance, angiography and histological examination with morphology were performed.
RESULTS: PCL grafts showed good mechanical properties and ease of handling. The average graft compliance was 14.5 ± 1.7%/ mmHg compared to 7.8 ± 0.9% for the abdominal position and 45.1 ± 3.2%/ mmHg for the native carotid artery. The overall patency for the carotid position was 65% as compared to 100% in the abdominal position. Complete endothelialisation was achieved at 3 weeks and cell invasion was more rapid than in the aortic position. In contrast, intimal hyperplasia (IH) and vascular density were less pronounced than in the aortic position.
CONCLUSION: Our PCL grafts in the carotid position were well endothelialised with early cellular infiltration, higher compliance, lower IH and calcification compared to the similar grafts implanted in the aortic position. However, there was a higher occlusion rate compared to our abdominal aorta series. Anatomical position, compliance mismatch, flow conditions may answer the difference in patency seen.

Matched MeSH terms: Aorta, Abdominal/physiopathology; Aorta, Abdominal/surgery*
Acute myelomonocytic leukaemia complicated by an acute aortic thrombosis

Leong KW, Bosco JJ, Shaik IB

Postgrad Med J, 1995 Feb;71(832):112-3.
PMID: 7724422

Acute aortic thrombosis is a rare condition, occurring mainly as a result of trauma or atherosclerosis and occasionally secondary to hypercoagulable states. We report a patient with relapsed acute myeloid leukaemia who developed an unusual complication, acute aortic thrombosis.

Matched MeSH terms: Aorta, Abdominal
Fulltext Multiple renal arteries with an ascending upward renal Vein of the right kidney: a case report

Al-Shibli S.M.

International Medical Journal Malaysia, 2014;13(1):57-60.
MyJurnal

As it is known; the majority of the human subjects has two renal arteries arising from the abdominal aorta; each will supply one kidney but in 30% of individuals, certain variations can be found. Accessory renal arteries constitute the most common and clinically important of these variations. For our case report, we are presenting one of these different variations that can be found in the blood supply of the kidneys. During dissecting the abdomen of an approximately 65 years-old male cadaver, multiple variations were found. There were double right renal arteries with prehilar branching of the upper renal artery. We found also that the right renal vein ascended upwards obliquely before ending in the lateral aspect of the inferior vena cava. Variation in the renal vessels is relatively common, especially multiple renal arteries, and can go smoothly without any abnormalities with the function of the kidney, but in some situations like renal transplantations, vascular reconstructions, and various surgical and radiological diagnostic techniques, the study of the anatomy of these variations is of crucial importance to decrease the patient morbidity during surgical procedures.

Matched MeSH terms: Aorta, Abdominal
Fulltext Superior Mesenteric Artery Syndrome in association with Abdominal Tuberculosis: An Eye Opener

Bhatt S, Mishra B, Tandon A, Manchanda S, Parthsarathy G

Malays J Med Sci, 2017 May;24(3):96-100.
PMID: 28814938 DOI: 10.21315/mjms2017.24.3.12

Superior Mesenteric Artery Syndrome (SMAS) is a rare clinical entity presenting as acute or chronic upper gastrointestinal obstruction. It occurs due to compression of third part of duodenum between abdominal aorta and overlying superior mesenteric artery caused by a decrease in angle between the two vessels. Rapid loss of retroperitoneal fat, in conditions leading to severe weight loss is the main factor responsible for this disorder. Superior mesenteric artery syndrome in association with abdominal tuberculosis has not been reported earlier to the best of our knowledge. Therefore, an unknown cause (SMAS) of upper gastrointestinal obstruction in a patient of abdominal tuberculosis is being presented for the first time through this case report. An imaging diagnosis of SMAS was made on contrast enhanced CT abdomen which also confirmed the clinical suspicion of abdominal tuberculosis in the patient. The patient was managed conservatively and recovered without requiring any surgical intervention for the obstructive symptoms.

Matched MeSH terms: Aorta, Abdominal
Salmonella related mycotic aneurysm with psoas and paraortic abscess treated conservatively

Abu Bakar A, Ngiu CS, Mohamad Said MS, Periyasamy P

Ann Acad Med Singap, 2011 Oct;40(10):467-8.
PMID: 22206056
Matched MeSH terms: Aorta, Abdominal/physiopathology
Fulltext β-Carotene Attenuates Angiotensin II-Induced Aortic Aneurysm by Alleviating Macrophage Recruitment in Apoe(-/-) Mice

Gopal K, Nagarajan P, Jedy J, Raj AT, Gnanaselvi SK, Jahan P, et al.

PLoS One, 2013;8(6):e67098.
PMID: 23826202 DOI: 10.1371/journal.pone.0067098

Abdominal aortic aneurysm (AAA) is a common chronic degenerative disease characterized by progressive aortic dilation and rupture. The mechanisms underlying the role of α-tocopherol and β-carotene on AAA have not been comprehensively assessed. We investigated if α-tocopherol and β-carotene supplementation could attenuate AAA, and studied the underlying mechanisms utilized by the antioxidants to alleviate AAA. Four-months-old Apoe(-/-) mice were used in the induction of aneurysm by infusion of angiotensin II (Ang II), and were orally administered with α-tocopherol and β-carotene enriched diet for 60 days. Significant increase of LDL, cholesterol, triglycerides and circulating inflammatory cells was observed in the Ang II-treated animals, and gene expression studies showed that ICAM-1, VCAM-1, MCP-1, M-CSF, MMP-2, MMP-9 and MMP-12 were upregulated in the aorta of aneurysm-induced mice. Extensive plaques, aneurysm and diffusion of inflammatory cells into the tunica intima were also noticed. The size of aorta was significantly (P = 0.0002) increased (2.24±0.20 mm) in the aneurysm-induced animals as compared to control mice (1.17±0.06 mm). Interestingly, β-carotene dramatically controlled the diffusion of macrophages into the aortic tunica intima, and circulation. It also dissolved the formation of atheromatous plaque. Further, β-carotene significantly decreased the aortic diameter (1.33±0.12 mm) in the aneurysm-induced mice (β-carotene, P = 0.0002). It also downregulated ICAM-1, VCAM-1, MCP-1, M-CSF, MMP-2, MMP-9, MMP-12, PPAR-α and PPAR-γ following treatment. Hence, dietary supplementation of β-carotene may have a protective function against Ang II-induced AAA by ameliorating macrophage recruitment in Apoe(-/-) mice.

Matched MeSH terms: Aorta, Abdominal/immunology; Aorta, Abdominal/pathology
Effects of Labisia pumila var alata extracts on the lipid profile, serum antioxidant status and abdominal aorta of high-cholesterol diet rats

Dianita R, Jantan I, Jalil J, Amran AZ

Phytomedicine, 2016 Jul 15;23(8):810-7.
PMID: 27288916 DOI: 10.1016/j.phymed.2016.04.004

BACKGROUND: Previous studies on Labisia pumila var. alata (LPva) have showed that it could inhibit low-density lipoprotein (LDL) oxidation and provide protection on myocardial infarction in rats.
HYPOTHESIS/PURPOSE: We hypothesized that LPva extracts can modulate the lipid profiles and serum antioxidant status of hypercholesterolemic rats. In the present study, we investigated the effects of aqueous and 80% ethanol extracts of LPva on atherogenic and serum antioxidant parameters as well as changes in abdominal aorta of high-cholesterol diet rats.
METHODS: The major components of the extracts, gallic acid, flavonoids and alkyl resorcinols were analyzed by using a validated reversed phase HPLC method. The rats were induced to hypercholesterolemic status with daily intake of 2% cholesterol for a duration of 8 weeks. Three different doses (100, 200 and 400mg/kg) of the extracts were administered daily on the 4th week onwards. The rats were then sacrificed and the blood was collected via abdominal aorta and serum was separated by centrifugation for biochemical analysis. Part of the aorta tissues were excised immediately for histopathological examination.
RESULTS: The serum of LPva treated rats showed significant reduction in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) levels and the abdominal aorta showed a significant decrease of atheroma lesions in treated rats. Serum lipid profiles of treated rats showed a decrease in total cholesterol, total triglycerides and low-density lipoprotein (LDL) levels as compared to control group. The atherogenic indices in treated rats were significantly improved along with an increasing level of serum high-density lipoprotein (HDL). The extracts also exhibited significant increase of antioxidant enzymes and decrease of MDA as a product of lipid peroxidation.
CONCLUSION: LPva extracts can reduce the risk of dyslipidemia by improving the serum lipid profiles and modulating serum antioxidants.

Matched MeSH terms: Aorta, Abdominal/drug effects*
Ultrasound screening of the abdominal aorta in Malaysians

Teoh MK, Ramasamy D, Wong KP

Aust N Z J Surg, 1992 Nov;62(11):862-5.
PMID: 20169704

Ultrasound examination of the abdominal aorta was performed on 100 patients with cardiovascular disease and a control group of 100 subjects. The objectives were to define the normal aortic size of Malaysians, to screen for aneurysms and to compare the aorta size of the different population groups. In the study group the mean anteroposterior (AP) diameter of the non-aneurysmal aortas at the level of the renal arteries was 1.82 cm (range 0.9-2.6 cm) in men and 1.83 cm (range 1.5-2.3 cm) in women. This compares with 1.61 cm (range 1.1-2.2 cm) in men and 1.50 cm (range 0.8-2.4 cm) in women in the control group. The dimensions of the infrarenal aorta show a similar relationship between the two groups. These AP diameters were significantly smaller than the published figures from studies done on Western populations and are consistent with the smaller stature of Malaysians. Five aneurysms and one ectasia were found (mean size 5 cm, range 3.5-6.0 cm), all in men aged 50-75 years in the study group, and none in the control group. All the aneurysms were easily palpable in these patients who were thinner than the average Caucasian. Given the lower incidence of aortic aneurysms in Malaysians there is no role for routine ultrasound screening of the population. High risk groups can be adequately screened by clinical examination alone.

Matched MeSH terms: Aorta, Abdominal/pathology*

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