Inflammatory aneurysms have a large perianeurysmal inflammatory mass (arrow). These aneurysms frequently require suprarenal aortic control and are often best managed via a retroperitoneal exposure. Therefore, recognizing them preoperatively allows planning. The duodenum (Dashed arrow) can be seen firmly adhered to the inflammatory mass. The duodenum should usually not be dissected from the aneurysmal neck as injury and intestinal spillage can occur.
Inflammatory aneurysms are thought to represent a spectrum of retroperitoneal fibrosis. Pain and elevated sedimentation rates are common findings. Ureteral obstruction can occur. Interestingly, the inflammation has been reported to regress following aortic graft placement.
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