International journal of surgery case reports · 2026
Double-layer repair of a tuberculous ascending aortic aneurysm: a case report and literature review.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pham Tran Viet Chuong, Cao Dang Khang, Huynh Huu Thang, Ho Duc Thang, Nguyen Hung Truong, Nguyen Hoang Dinh
Аннотация
INTRODUCTION AND IMPORTANCE: Tuberculous aneurysm of the ascending aorta is extremely rare and life-threatening, particularly in elderly patients. Early recognition and appropriate surgical management are essential to prevent fatal rupture.
CASE PRESENTATION: An 84-year-old man presented with hemoptysis and chest tightness. Computed tomography revealed a saccular aneurysm of the ascending aorta with sternal erosion. During surgery, the aneurysm showed a caseous appearance with dense adhesions and infiltration into adjacent tissue. Frozen section demonstrated granulomatous inflammation suggesting tuberculous aortitis, which was later confirmed by postoperative Xpert MTB/RIF assay. A double-layer aortic repair was performed using an inner bovine pericardial patch and an outer Gelweave graft. The patient recovered well under antituberculous therapy and remained stable at 7-month follow-up.
CLINICAL DISCUSSION: Tuberculous aortitis in elderly patients is challenging due to degenerative aortic wall changes and hypertension. Intraoperative frozen section combined with gross findings played a key role in guiding the surgical strategy. The double-layer repair provided infection control and mechanical durability, consistent with current literature supporting biologic-synthetic hybrid reconstruction in infected aneurysms.
CONCLUSION: A tuberculous aneurysm of the ascending aorta should be considered in atypical cases presenting with hemoptysis. In elderly patients with degenerative aortic walls and hypertension, double-layer repair offers effective infection control and durability when combined with appropriate antituberculous therapy. Early diagnosis and tailored surgical planning are crucial for favorable outcomes.
CASE PRESENTATION: An 84-year-old man presented with hemoptysis and chest tightness. Computed tomography revealed a saccular aneurysm of the ascending aorta with sternal erosion. During surgery, the aneurysm showed a caseous appearance with dense adhesions and infiltration into adjacent tissue. Frozen section demonstrated granulomatous inflammation suggesting tuberculous aortitis, which was later confirmed by postoperative Xpert MTB/RIF assay. A double-layer aortic repair was performed using an inner bovine pericardial patch and an outer Gelweave graft. The patient recovered well under antituberculous therapy and remained stable at 7-month follow-up.
CLINICAL DISCUSSION: Tuberculous aortitis in elderly patients is challenging due to degenerative aortic wall changes and hypertension. Intraoperative frozen section combined with gross findings played a key role in guiding the surgical strategy. The double-layer repair provided infection control and mechanical durability, consistent with current literature supporting biologic-synthetic hybrid reconstruction in infected aneurysms.
CONCLUSION: A tuberculous aneurysm of the ascending aorta should be considered in atypical cases presenting with hemoptysis. In elderly patients with degenerative aortic walls and hypertension, double-layer repair offers effective infection control and durability when combined with appropriate antituberculous therapy. Early diagnosis and tailored surgical planning are crucial for favorable outcomes.