[A case of inflammatory abdominal aortic aneurysm with associated inferior vena caval and bilateral ureteral obstruction]

One year ago, a 48-year-old man complained of dyspnea, and was diagnosed as mitral valve regurgitation and aortic dissection. He underwent mitral valve replacement and aortic arch grafting. He was also pointed out to have an inflammatory aortic aneurysm (IAAA) in the infrarenal abdominal aorta, but did not undergo surgery. At this admission, he had lumbago and low grade fever probably due to deterioration of the IAAA. On the preoperative radionuclide studies, inferior vena caval obstruction and bilateral ureteral obstruction or severe stenosis were demonstrated by 99mTc-MAA venography and 123I-OIH renogram, respectively. 67Ga scan showed faint abnormal accumulation at the IAAA. He underwent surgery. IAAA had a thick wall in white and hard fibrotic tissue adhered closely to duodenum, jejunum, inferior vena cava and bilateral ureters. After surgery, his renal function was improved. In this case, radionuclide studies were useful for detecting the inferior vena caval obstruction, assessing renal function and inflammatory activity.