Tuberculous pseudoaneurysm of the abdominal aorta (TBAA) is an exceedingly rare, but fatal complication of the tuberculosis, especially in the condition of the disseminated tuberculosis. We reported a case of TBAA treated successfully by surgical and medical therapy. A 65-year-old woman admitted to our hospital complaining of sudden abdominal pain, nausea and vomiting for 3 days. She underwent 4 times operation of orthopedic surgery for tuberculous spondylitis at the level of the L4-5, T5-7, tuberculous epidural abscess, both psoas abscess, and had been receiving antituberculous medications for disseminated miliary tuberculosis at the both lung fields. Soon after this, she developed aggravated abdominal pain and we examined contrast enhanced abdominal CT scan and revealed saccular, thrombosed aneurysmal dilatation on the level of the aortic bifurcation. We performed elective operation for direct closure of the small rent at the anterior wall of the abdominal aorta after confirming no active inflammatory reaction on the frozen biopsy. Currently, the patient is an antituberculous medications without any surgical complication for 12 months after operation.
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