A CASE REPORT OF JUXTARENAL AORTIC OCCLUSION DUE TO NONSPECIFIC ANGITIS

A rare case of juxtarenal aortic occulusion probably due to so-called nonspecific angitis of unknown origin is reported. A 46-year-old man who had been suffering from intermittent claudication within 200 meters from the age of 38 when he was suspected of Buerger disease at another hospital was admitted to the hospital because of exacerbation of the symptom. He had not received any treatment. On admission angiography showed juxtarenal abdominal aortic occlusion involving the bilateral common iliac arteries, and the peripheral arteries were patent via the collateral circulations. Severe calcification and thrombotic occlusion of the abdominal aorta were identified by the abdominal CT scan. Under the diagnosis of juxtarenal aortic occlusion due to atherosclerotic disease, we performed an aortobifemoral bypass grafting using a Y-shaped e-PTFE prosthesis followed by thromboendarterectomy of the juxtarenal aorta, and severe inflammatory lesion was found out at the operation around the abdominal aorta. Histopathological examinations of the resected specimen revealed an infiltration of inflammatory lymphocytes in the aortic wall, and a diagnosis of aortitis syndrome was made. It is difficult to diagnose this case as aortitis syndrome clinically, howerver, we supposed this case as so-called nonspecific angitis or one of the subgroups of atherosclerotic disease.