A rare case of clostridium septicum mycotic aortic arch aneurysm following open right hemicolectomy for colorectal cancer

Hadi, Hasan Imam Al; Patel, Gaural; Rees, Michael

doi:10.1136/bcr-2014-204636

Cited by 4 publications

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References 2 publications

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“…The search yielded 55 studies published between 1976 and 2015 that were narrowed by the following exclusion criteria: absence of both aortitis and colon adenocarcinoma, aortitis due to organisms other than C. septicum , patient outcomes not addressed, presenting with aortic rupture, and paper not available in English. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 …”

Section: Discussionmentioning

confidence: 99%

A rare case of Clostridium septicum aortitis with colon adenocarcinoma

Shahi

Arosemena

Kwon

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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Clostridium septicum aortitis is a rare, highly morbid condition typically accompanied by malignant disease, such as hematologic cancer or colon adenocarcinoma. Presenting symptoms commonly described include acute onset of abdominal pain, nausea, and fevers. Prompt diagnosis of infectious aortitis is critical to prevent deadly complications, such as sepsis and vascular catastrophe. The described management largely involves surgical resection of the infected aorta, débridement, and arterial revascularization through extra-anatomic bypass or aortic graft placement.

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Section: Discussionmentioning

confidence: 99%

A rare case of Clostridium septicum aortitis with colon adenocarcinoma

Shahi

Arosemena

Kwon

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

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Candida albicansmycotic aneurysm of aortic arch following laparoscopic right hemicolectomy for colon cancer

2021

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An 81-year-old man was referred to the colorectal surgeons for an elective laparoscopic right hemicolectomy for a caecal adenocarcinoma (T2N0M0). The operation was uneventful; however, 12 days postoperatively the patient developed symptoms of sepsis of unknown origin. After extensive investigations and work up, Candida albicans was grown as the causative organism with the site of infection being a new saccular mycotic aneurysm arising from the distal, posterior aspect of the aortic arch. The mycotic aneurysm was not initially considered as a differential diagnosis, and this case highlights the importance of consideration of mycotic aneurysm as a differential diagnosis in postsurgical septic patients.

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Presence of periaortic gas in Clostridium septicum-infected aortic aneurysm aids in early diagnosis: a case report and systematic review of the literature

et al. 2017

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Background Clostridium septicum-infected aortic aneurysm is a fatal and rare disease. We present a fatal case of C. septicum-infected aortic aneurysm and a pertinent literature review with treatment suggestions for reducing mortality rates.Case presentationA 58-year-old Japanese man with an unremarkable medical history presented with a 3-day history of mild weakness in both legs, and experienced paraplegia and paresthesia a day before admission. Upon recognition of signs of an abdominal aortic aneurysm and paraplegia, we suspected an occluded Adamkiewicz artery and performed a contrast-enhanced computed tomography scan, which revealed an aortic aneurysm with periaortic gas extending from his chest to his abdomen and both kidneys. Antibiotics were initiated followed by emergency surgery for source control of the infection. However, owing to his poor condition and septic shock, aortic repair was not possible. We performed bilateral nephrectomy as a possible source control, after which we initiated mechanical ventilation, continuous hemodialysis, and hemoperfusion. A culture of the samples taken from the infected region and four consecutive blood cultures yielded C. septicum. His condition gradually improved postoperatively; however, on postoperative day 10, massive hemorrhage due to aortic rupture resulted in his death.ConclusionsIn this patient, C. septicum was thought to have entered his blood through a gastrointestinal tumor, infected the aorta, and spread to his kidneys. However, we were uncertain whether there was an associated malignancy.A literature review of C. septicum-related aneurysms revealed the following: 6-month mortality, 79.5%; periaortic gas present in 92.6% of cases; no standard operative procedure and no guidelines for antimicrobial administration established; and C. septicum was associated with cancer in 82.5% of cases.Thus, we advocate for early diagnosis via the identification of periaortic gas, as an aortic aneurysm progresses rapidly. To reduce the risk of reinfection as well as infection of other sites, there is the need for concurrent surgical management of the aneurysm and any associated malignancy. We recommend debridement of the infectious focus and in situ vascular graft with omental coverage. Postoperatively, orally administered antibiotics must be continued indefinitely (chronic suppression therapy).We believe that these treatments will decrease mortality due to C. septicum-infected aortic aneurysms.

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A rare case of clostridium septicum mycotic aortic arch aneurysm following open right hemicolectomy for colorectal cancer

Cited by 4 publications

References 2 publications

A rare case of Clostridium septicum aortitis with colon adenocarcinoma

A rare case of Clostridium septicum aortitis with colon adenocarcinoma

Candida albicansmycotic aneurysm of aortic arch following laparoscopic right hemicolectomy for colon cancer

Presence of periaortic gas in Clostridium septicum-infected aortic aneurysm aids in early diagnosis: a case report and systematic review of the literature

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