The infrequent association of abdominal aortic aneurysms with extensive periaortic fibrosis has been described in the vascular surgical literature as inflammatory aortic aneurysms. The relationship of this process to idiopathic retroperitoneal fibrosis is unclear, but cases presenting with obstructive uropathy secondary to perianeurysmal fibrosis have been described in the urological literature. Since this entity is readily detected by sonography, it should be sought in patients presenting with abdominal aortic aneurysms. A case of abdominal aortic aneurysm with periaortic fibrosis is presented.
CASE REPORTA 70-year-old white male presented with a 4-month history of sharp, episodic right lower quadrant pain more recently involving the right paraspinal region. The patient was known to have mild hypertension treated by dyazide but was receiving no other drugs. He had undergone a right upper lobectomy for carcinoma of the lung 2 years previously with no evidence of recurrence.Physical examination revealed a 5-cm diameter pulsatile, abdominal mass. Peripheral pulses were good. An aortogram demonstrated a typically appearing infrarenal abdominal aortic aneurysm. The kidneys, collecting systems, and ureters also were normal. Preoperative laboratory studies demonstrated a mild anemia and leukocytosis. The erythrocyte sedimentation rate was elevated and there was hyperglobulinemia. The serological test for syphilis was negative. The BUN and creatinine were slightly elevated to 24