1
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Rotura aórtica masiva secundaria a espondilodiscitis por Staphylococcus aureus Translated title: Massive aortic rupture secondary to Staphylococcus aureus spondylodiscitis

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen Introducción: presentamos un caso inusual de rotura aórtica múltiple secundaria a espondilodiscitis por Staphylococcus aureus sensible a meticilina. Caso clínico: varón de 71 años que ingresa en nuestro hospital para el estudio programado de una espondilodiscitis T7-T8 refractaria a tratamiento empírico antibiótico. El decimoquinto día de su ingreso el paciente presenta una hematemesis masiva con dos paradas cardiorrespiratorias. Tras ser reanimado en dos ocasiones, se realiza una endoscopia en el quirófano que sugiere la presencia de una fístula aortoentérica primaria. A su vez, en una tomografía computarizada de seguimiento se evidencia sangrado activo en la aorta torácica. Realizamos una angiografía diagnóstica en la que apreciamos tres puntos de ruptura aórtica. Se precisa la implantación de endoprótesis cubiertas para el control del sangrado: un dispositivo en la aorta torácica (Gore C-TAG®) y otro a nivel abdominal (Aortic Begraft®). Discusión: la aortitis es una complicación poco común de la espondilodiscitis con una tasa alta de mortalidad. Un alto índice de sospecha es clave para su temprano diagnóstico y tratamiento. La antibioterapia es obligatoria y el tratamiento endovascular puede usarse como terapia puente en emergencias. Es un procedimiento rápido que permite la estabilización hemodinámica del paciente antes de una cirugía abierta aórtica definitiva.

          Translated abstract

          Abstract Introduction: we present an unusual case with multiple aortic ruptures secondary to methicillin-sensitive Staphylococcus aureus thoracic spondylodiscitis. Case report: the patient was a 71-year-old man admitted to our hospital for scheduled study of an infectious spondylodiscitis D7-D8 refractory to empirical antibiotic therapy. Fifteen days after admission, the patient began with massive hematemesis. After being resuscitated from two cardiac arrests, an endoscopy was carried out in the operating room suggesting presence of a primary aortoenteric fistula and, at the same time, in a follow-up computed tomography an active bleeding in thoracic aorta was shown. We performed a diagnostic angiography; three different sites of rupture were observed and two covered endogfrats were placed for bleeding control of thoracic and abdominal aorta: one device in thoracic aorta (Gore C-TAG®) and another one in abdominal aorta (Aortic Begraft®). Discussion: aortitis is an uncommon complication of spondylodiscitis, with a high mortality rate. A high index of suspicion is key to its diagnosis and prompt treatment. Antibiotherapy is mandatory and endovascular treatment can be used as a bridge therapy in emergency, it is a fast procedure that can secure hemodynamical stabilization prior to definitive aortic open repair.

          Related collections

          Most cited references10

          • Record: found
          • Abstract: found
          • Article: not found

          Nationwide Study of the Treatment of Mycotic Abdominal Aortic Aneurysms Comparing Open and Endovascular Repair

          No reliable comparative data exist between open repair (OR) and endovascular aneurysm repair (EVAR) for mycotic abdominal aortic aneurysms (MAAAs). This nationwide study assessed outcomes after OR and EVAR for MAAA in a population-based cohort.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Editor's choice – European Society for Vascular Surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms

              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extra-anatomic repair in 33 cases

                Bookmark

                Author and article information

                Journal
                angiologia
                Angiología
                Angiología
                Arán Ediciones S.L. (Madrid, Madrid, Spain )
                0003-3170
                1695-2987
                June 2022
                : 74
                : 3
                : 131-134
                Affiliations
                [1] Zaragoza orgnameHospital Universitario Miguel Servet orgdiv1Servicio de Angiología, Cirugía Vascular y Endovascular Spain
                Article
                S0003-31702022000300131 S0003-3170(22)07400300131
                10.20960/angiologia.00361
                38728140-8708-4d4e-a9e3-cf6b79f9e080

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 21 November 2021
                : 28 October 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 4
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                Discitis,Aortitis,Procedimientos endovasculares,Rotura aórtica,Endovascular procedures,Aortic rupture

                Comments

                Comment on this article