PMC9126945_01
Computed tomography (CT) in axial (A) and coronal (B) view on admission demonstrating a 4.5 cm aortic aneurysm with inflammation of fatty tissue and fluid surrounding the aorta. 18F-fludeoxyglucose (FDG) positron emission tomography/low dose (ld) CT scan in axial (C) and coronal (D) view demonstrating significant heterogeneous FDG uptake of the aortic wall and an increase in diameter of the aortic aneurysm from 4.5 to 5.0 cm. FDG uptake was observed in retroperitoneal lymph nodes most likely reactive to the infected arterial wall. The spleen and bone marrow also showed weak uptake suggestive of an active infection. Physiological FDG uptake was seen in the brain and myocardium with signs of renal tracer excretion.
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A computed tomography (CT) scan with intravenous contrast demonstrated a 4.5 cm infrarenal abdominal aortic aneurysm with signs of inflammation and fluid around the aneurysm down to the iliac vessels, suggestive of a mycotic aneurysm (Fig. 1A and B). An 18F-fludeoxyglucose (FDG) positron emission tomography (PET)/low dose (ld) CT scan was performed three days after admission showing significant heterogeneous FDG uptake in the soft tissue surrounding the aneurysm and in surrounding lymph nodes without signs of increased uptake elsewhere (Fig. 1C and D).
Intra-operative image of the bioprosthesis before (A) and after placement with the surrounding infected aortic wall (B).
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A 21 mm x 15 cm bovine bioprosthesis (BioIntegral Surgical, Canada) was used for interposition and sutured to healthy infrarenal aorta (Fig. 2).