NORMAL large elastic arteries are remarkably resistant to infection.1,2 However, when congenital or acquired vascular abnormalities exist, this resistance may be compromised. For some unknown reason, enteric pathogens demonstrate a predilection for invasion of such abnormal vessels and members of the Salmonella group in particular are the most frequent offenders. Areas of arteriosclerotic change within large vessels are the usual site of bacterial invasion and aneurysmal rupture is the usual outcome.
Prior to the advent of reconstructive vascular surgery, the ruptured abdominal aneurysm was largely a curiosity of academic interest. As vascular surgery was introduced it soon became apparent that infection was probably the gravest complication associated with reconstructive procedures. When infection exists prior to surgery, the chance of success is remote unless the infectious process can be eradicated.
This report is prompted by a recent experience with a ruptured arteriosclerotic abdominal aortic aneurysm associated with salmonellosis. A review
DeMuth WE, McConaghie RJ. Salmonella Infection in Ruptured Abdominal Aortic Aneurysm. Arch Surg. 1967;95(2):193-197. doi:10.1001/archsurg.1967.01330140031008