RESUMEN
BACKGROUND CONTEXT: Pseudoaneurysm of the aorta in association with vertebral tuberculosis is a rare phenomenon. With the resurgence of human immunodeficiency virus (HIV) and associated resistant tuberculosis, this life-threatening complication requires greater awareness. PURPOSE: Our purpose is to report the rare presentation and successful management of tubercular pseudoaneurysm of the aorta in association with vertebral tuberculosis, and to highlight the clinicoradiological features for early and prompt diagnosis of this potentially fatal, but treatable, disease. STUDY DESIGN: A single case report and overview of the disease comprises the design of this study. PATIENT SAMPLE: The patient, already surgically intervened, is a 27-year-old male with increasing abdominal and back pain, upper motor neuron signs, and constitutional signs and symptoms. OUTCOME MEASURES: At 33 months follow-up, there is complete resolution of the signs and symptoms, and the patient is back to his previous vocation. METHODS: The diagnosis was confirmed by magnetic resonance imaging and contrast computed tomography. Endoaneurysmorrhaphy of the pseudoaneurysm along with a complete course of antitubercular treatment was given to the patient, and he has presently been followed up for 33 months. RESULTS: The patient's signs and symptoms have been completely resolved without any recurrence. CONCLUSION: Despite the use of modern chemotherapy and imaging techniques, this disastrous complication still occurs and reinforces the need for early suspicion, diagnosis, surgical resection, and antitubercular therapy along with close postoperative follow-up to prevent recurrence. With the resurgence of HIV (and other immunocompromised states) associated and resistant tuberculosis, we should be more alert than ever to this life-threatening complication.
Asunto(s)
Aneurisma Falso/microbiología , Aorta/microbiología , Tuberculosis Osteoarticular/complicaciones , Adulto , Aneurisma Falso/patología , Aneurisma Falso/cirugía , Aorta/patología , Aorta/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Columna Vertebral , Tomografía Computarizada por Rayos X , Tuberculosis Osteoarticular/diagnóstico por imagen , Tuberculosis Osteoarticular/patologíaRESUMEN
INTRODUCTION: Though physeal injuries are common in children, concomitant multiple closed contiguous physeal injuries in a limb along with vascular compromise are rare. An associated distractional-separation type of physeal injury is being documented for the first time. We present here two such cases. MATERIALS AND METHODS: Two children, aged 6 months and 3 years, respectively, suffered a roadside high velocity trauma and thus form the part of this case report. RESULTS: Because of the delay in seeking treatment and, or, the nature of injuries, it was associated with a tragic complication--an amputation in both cases. CONCLUSION: Although, the limb in our cases could not be salvaged, these reports describe these unusual injury patterns for the first time and re-emphasize the awareness of urgent recognition of the associated vascular insult.