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March 1968

Primary Mycotic Aneurysm of the Right Common Iliac ArteryCondition Producing Hydronephrosis and Hydroureter and Duodenal Fistula

Author Affiliations

Ann Arbor, Mich
From the Department of Surgery, Section of Urology, University of Michigan Medical Center, Ann Arbor.

Arch Surg. 1968;96(3):373-377. doi:10.1001/archsurg.1968.01330210051009

A MYCOTIC aneurysm is the result of bacterial disruption of the arterial wall or myocardium. Eighty percent of these lesions occur in patients suffering from subacute bacterial endocarditis septic embolization. The remaining 20% includes type mycotic aneurysms caused by direct extension of contiguous infection into the arterial wall and those which occur as a complication of bacteremia from a distant extravascular infectious process.1 The first group has been termed embolomycotic. The third group is recognized under the category of primary mycotic or cryptogenic aneurysms.2 The case reported herein belongs to the latter group.

Generally speaking, an aneurysm, regardless of its etiology, is recognized clinically by palpation when its size and location allow the examiner to detect a pulsatile mass. Sometimes, however, their presence is established when the symptoms produced by irritation in the surrounding structures are investigated or when rupture occurs. This sequence of events is well illustrated

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