The Management of Abdominal Aortic Salmonellosis

Abstract

Infection of the abdominal aorta by Salmonella organisms is a rare but com monly fatal condition. Successful man agement depends on rapid diagnosis, ag gressive surgical intervention, extra- anatomic vascular reconstruction and antibiotic therapy.

A review of the surgical literature re veals 25 cases of Salmonella aortitis with only five survivors. Pre-operative death from aortic rupture is common and post operative death due to graft infection is to be anticipated if a prosthesis is placed in the normal retroperitoneal location.

A successfully managed case is pre sented with a three year follow-up. Therapy consisted of aneurysm resection, axillobifemoral bypass and a six week course of antibiotics. The status of the oversewn aortic stump has been followed at yearly intervals by means of the in travenous digital subtraction angiogram. No aneurysmal dilatation of the aortic stump has occurred during the three year follow-up and the extra-anatomic recon struction has remained patent without the need for thrombectomy. Important con siderations in the operative and post operative management are discussed.