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Luetic aneurysm

The Luetic aneurysm ( also called syphilitic aneurysms ) are usually secondary to syphilitic aortitis

Epidemiology

Pending

Pathology

The responsible organism is a spirochete Treponema pallidum and Ascending aorta is mostly involved.

Syphlitic aortitis takes place during the stage of tertiary syphilis between 5 to 30 years after initiation of primary syphilis. This is normally due to infection of aorta secondary to endarteritis obliterans of vasa-vasarum.

Aortic wall becomes progressively weakened due to chronic inflammation. This will subsequently lead to aneurysm (10%), coronary artery Narrowing at ostium (30%) and aortic valve insufficiency secondry to the involvement of aortic valve.

Clinical presentation

Pending

Radiographic features

Angiography

The findings are :

  • Saccular asymmetric aortic aneurysm
  • Aortic root branches involvement

We can not accurately measure aneurysm by using angiography. This is normally due to intra-aneurysmal/ mural thrombosis and calcification, layering of the contrast and magnification.,

CT scan

The findings of CT may include :

  • Extensive thickening of aortic wall with peri-aortic inflammation.
  • Asymmetrical aortic sinus involvement.
  • Saccular aneurysms and heavily calcified ascending aorta.
  • Tree bark intimal calcifications due to intimal wrinkling.
MRI

Pending

Treatment

High dose antibiotic and resection of enlarging aneurysm.

Differential diagnosis

Pending

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