Ruptured giant syphilitic aneurysm of the descending aorta in an octogenarian

Journal of Cardiac Surgery
Torsten BossertF W Mohr

Abstract

Syphilis can lead to saccular aneurysms of the thoracic aorta. Today syphilitic aortic aneurysms are rare. The average time from primary infections to the development of aortic aneurysms is 10 to 15 years. An 83-year-old man was admitted with a giant aneurysm of the descending thoracic aorta. The patient had first experienced subacute pain in the left hemithorax some weeks previously. Computer tomography scan detected an 11 x 11 cm aneurysm of the descending aorta. Serodiagnostic tests for syphilis were highly positive. Femoro-femoral bypass was initiated and a tube graft was interposed. The postoperative course was uneventful, the patient was discharged at the twentieth postoperative day. Histological examination of the aneurysmal wall showed typical syphilitic changes. Postoperatively, Penicillin G was given for 6 months. Three years later the patient remains asymptomatic. Although extremely rare today, tertiary syphilis should be considered in the differential diagnosis of thoracic aneurysms. In selected octogenarians replacement of the descending aorta is possible.

References

Jan 1, 1992·European Journal of Vascular Surgery·D J AlexanderR L Doig
Oct 1, 1989·The American Journal of Medicine·J D Jackman, J D Radolf
Jan 1, 1996·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·J O FultonU O Von Oppell
Dec 22, 1998·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·P LemkeK Hellberg
Feb 25, 2003·JAMA : the Journal of the American Medical Association·Joan Stephenson

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Citations

Aug 29, 2012·Journal of the Neurological Sciences·Seid Ali Gugssa, James C Johnston
Sep 4, 2013·General Thoracic and Cardiovascular Surgery·Yuji SekineShiro Sasaguri
Aug 4, 2018·Zeitschrift für Rheumatologie·S-M Yuan
Feb 28, 2006·British Journal of Hospital Medicine·Venkatesh SaravananAbu Nasar

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