Chronic Periaortitis – Review and Presentations
Savita Taribagil
Department of Surgery, Queen Elizabeth NHS Foundation Trust, Gateshead, UK.
Sabrina Bhattacharya
Royal Victoria Infirmary, Newcastle upon Tyne NHS Foundation Trust, UK.
Priyal Taribagil
Barnet Hospital, Royal Free London NHS Foundation Trust, UK.
Vadivelu Saravanan
Queen Elizabeth Hospital NHS Foundation Trust, Gateshead, UK.
Vish Bhattacharya
Queen Elizabeth Hospital NHS Foundation Trust, Gateshead, UK.
*Author to whom correspondence should be addressed.
Abstract
Chronic periaortitis is a rare inflammatory condition predominantly affecting the abdominal segment of the aorta. This can present as IgG4 related inflammatory disease, idiopathic retroperitoneal fibrosis, perianeurysmal retroperitoneal fibrosis and inflammatory abdominal aortic aneurysm (IAAA). Aortitis can also be a manifestation of a number of rheumatological large vessel vasculitides such as Takayasu arteritis and giant cell arteritis (GCA). We present three interesting cases of chronic periaortitis and a literature review. The first case shows a classic picture of IgG4 periaortitis. The second case illustrates periaortitis with retroperitoneal fibrosis, ureteric involvement and hydronephrosis, following abdominal aortic aneurysmal stenting. The final case presents as widespread periaortitis due to Takayasu's disease involving the entire aorta including the arch and root of the subclavian artery.
Keywords: Periaortitis, IgG4 related disease, retroperitoneal fibrosis, Takayasu's disease, FDG- PET scan, CT scan, corticosteroids