Ruptured descending thoracic aortic aneurysm due to aortitis syndrome--a case report

Ruptured fusiform descending thoracic aortic aneurysms due to aortitis syndrome are rare. A 29-year-old woman was readmitted to our hospital with a chief complaint of back pain and shock, and diagnosed as having rupture of a descending thoracic aortic aneurysm. She had a past history of aortitis syndrome beginning eight years ago. On chest CT examination earlier a year, the descending thoracic aortic aneurysm was 4.5 cm in diameter, and calcification we observed in the aortic wall. An inflammatory reaction had been controlled by steroid therapy and her blood pressure had been controlled by vasodilator drugs. Emergent graft replacement of a descending aortic aneurysm was successfully performed under a femoro-femoral bypass using a centrifugal pump and membrane oxygenerator, and Cell Sver. Although in the literature surgical treatment is indicated only if there is a symptomatic or enlarging aneurysm especially of saccular type and no operation is justified for an aortic aneurysm showing marked calcification, we concluded that aggressive surgical treatment was necessary for this fusiform aneurysm due to aortitis syndrome.