AB206. Infectious aortitis presenting as a perforated sigmoid colon and inflamed abdominal aortic aneurysm

Background: Aortitis is an extensive term that refers to inflammation of the aorta. Aortitis can be categorised into two groups non-infectious and infectious, with Salmonella spp being the most commonly associated organism with infectious aortitis. We report a case of a 58-year-old man who presented with a case of infectious aortitis due to perforated sigmoid colon and a 4 cm inflamed abdominal aortic aneurysm (AAA).

Methods: Data was collected from patient’s chart and electronic database, laboratory and radiology systems.

Results: Based on laboratory investigations, chest X-ray and computed tomography angiography (CTA) the original treatment plan was to treat with best medical therapy. However, the patient’s abdominal pain progressed to severe and he became hypotensive and was taken to theatre. The patient was treated with a joint emergency Hartmann’s procedure for a perforated sigmoid colon and an open repair for his inflamed abdominal aortic aneurysm (AAA). Laboratory investigations revealed the organism associated with aortitis was Escherichia coli.

Conclusions: Infectious aortitis, often presents with vague symptoms but carries a high rate of complications and mortality. This case is unique because most cases are non-infectious and the organism most commonly isolated is the Salmonella species.

Keywords: Infectious aortitis; abdominal aortic aneurysm; Hartmann’s procedure