CASE REPORT: Infectious Aneurysm Formation After Depot Acupuncture

Introduction The infra-renal abdominal aorta, including the aneurysm and the bilateral iliac arteries, were removed Acupuncture has become prevalent not only in Asia with debridement of infected tissues in order to prevent infection. The aorta was replaced with a but also worldwide for the treatment of chronic pain. Depot acupuncture involves the implantation of sheep polytetrafluoroethylene (PTFE) Y-graft, which was covered with omental flaps. The proximal and distal plain ‘‘gut’’ thread into the ‘‘meridian point’’ through a spinal-anesthesia needle. It is claimed that this type anastomoses were sewn with continuous sutures of 4-0 and 5-0 Gore-Tex, respectively. Histologically, the of acupuncture is more effective than conventional acupunctures and that it is effective for waist pain, aneurysmal wall showed an abrupt disruption of the medial elastic lamellae (Fig. 2a) and consisted glaucoma, gastric ulcer, uteric myoma and several other diseases. of the adventitia only. Many lymphocytes and few neutrophils aggregated in the adventitia of the aneurysm. No bacteria were detected. Several foreignbody-type giant cells were scattered in the wall (Fig. Case Report 2b). Antibiotics (cefazolin sodium and isepamicin sulphate) were administered intravenously for 8 days A 67-year-old man was admitted with high fever postoperatively. Although he suffered from transient (39.2 °C) and intractable back pain for 1 month. ischemic colitis postoperatively, he recovered and White cell count was 11 900 mm and C reactive has not shown any recurrence 2 years after the protein level was 20.6 mg/dl. He had received depot operation. gut therapy twice, 6 and 7 months before admission. Computed tomography revealed a low density mass in the left psoas muscle and the ventral portion of Discussion the distal aorta (Fig. 1a). The former was an abscess and the latter was a false aneurysm. Angiography There are many reports of complications after acushowed an aortic false aneurysm (Fig. 1b). At puncture. However, to our knowledge, this is the first operation, there was inflammation of peritoneum report of infectious aneurysm and only the fourth and firm adherence of the aneurysm to the vertebrae. reported case of pseudoaneurysm after acupuncture. Culture of the granulation tissue was negative. Fujiwara et al. reported a case of pseudoaneurysm of Atherosclerotic changes of the aorta were severe. the costicervical artery after insertion of 20–30 acupuncture needles around the shoulders, mostly along the spina scapulae. Lord reported a case of false ∗ Please address all correspondence to: N. Origuchi, Department of aneurysm of the popliteal artery. Matsuyama reported Vascular Surgery, The University of Tokyo, 7-3-1 Hongo, Bunko-ku, Tokyo 113-8655, Japan. a case of retroperitoneal hematoma due to rupture of