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An endoluminal aortic prosthesis infection presenting as pneumoaorta and aortoduodenal fistula

Yung-Ta Kao1, Chun-Ming Shih, Feng-Yen Lin

  • 1Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan, China.

World Journal of Gastroenterology
|October 16, 2012
PubMed

Insights

A rare case of aortoduodenal fistula (ADF) and pneumoaorta resulted from infected aortic stent graft. Despite intensive care and surgery, the patient succumbed to septic shock, highlighting the critical nature of these complications.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Endovascular aneurysm repair (EVAR) is a common treatment for abdominal aortic aneurysms.
  • Infection of endovascular aortic prostheses is a rare but serious complication.
  • Aortoduodenal fistula (ADF) is a life-threatening condition characterized by an abnormal connection between the aorta and the duodenum.

Observation:

  • An 82-year-old male presented with bloody diarrhea two months post-EVAR for an abdominal aortic aneurysm.
  • Imaging revealed an infected aortic stent graft and an aortoduodenal fistula (ADF).
  • The patient developed septic shock despite emergency surgical intervention and intensive care.

Findings:

  • The patient's death was attributed to overwhelming septic shock secondary to the infected aortic prosthesis and ADF.
  • This case underscores the challenges in managing infected aortic endografts and associated fistulas.
  • Pneumoaorta, a rare finding, was also noted in conjunction with the infected prosthesis.

Implications:

  • Prompt diagnosis and management of infected aortic stent grafts are crucial.
  • Aggressive antibiotic therapy combined with graft explantation is indicated for stent graft infections.
  • Early recognition and surgical management of aortoduodenal fistulas are vital for patient survival, even in the presence of septic shock.
Keywords:
Aortoduodenal fistulaEndovascular aneurysm repairInfectionShockStent graft

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