Ruptured tuberculous aneurysms of the abdominal aorta: Two case series

BACKGROUND: Ruptured aneurysms secondary to the tuberculous infection of the aorta are a rare and life-threatening disease. We report a single-center experience of two patients with ruptured infrarenal tuberculous aneurysms. CASE PRESENTATION: We report 2 patients with ruptures of the tuberculous aneurysm. All patients had acute abdominal pain and were diagnosed by echography then CT scan preoperatively. The first patient (male, 50 years old) had a ruptured saccular aneurysm. The second patient (male, 43 years old) had a retroperitoneal contained rupture. All were treated by open prosthetic repair, by vascular surgeons. The two patients were well after operations. The diagnosis was confirmed by pathology examination. Antituberculous treatment was introduced after the operation. CONCLUSIONS: Ruptured tuberculous aneurysms are rare but life-threatening. The diagnosis requires a high degree of suspicion. The treatment includes early diagnosis and emergent surgical intervention, extensive excision of infected field, aortic reconstruction, and prolonged antituberculous drug therapy.