Isolated periaortitis

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Abdominal pain

Patient Data

Age: 65
Gender: Male

CT abdomen with contrast

ct

Soft tissue density is noted surrounding the entire length of the abdominal aorta with showed in addition irregular caliber with mural thrombi and ulcerating plaques. The process is seen implicating the celiac axis, notably its origin.

Other findings: Interruption of the lateral abdominal wall at the left lumbar region with fat herniation (lumbar hernia), scanty descending colon uncomplicated diverticulosis and bilateral fractured pars interarticularis of the 5th lumbar vertebra.

Case Discussion

Isolated periaortitis is a non-aneurysmal and less common form of chronic periaortitis. It is an inflammatory condition which typically involves the infrarenal portion of the abdominal aorta. An exaggerated inflammatory response due to advanced atherosclerosis is thought to be the main pathogenic process. Autoimmunity has been proposed as a contributing factor.

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