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[Aortic paraprosthetic infection. Diagnostic and therapeutic difficulties. Apropos of a case]

P Aknin1, M Latiere, B Eon

  • 1Département d'Anesthésie-Réanimation, Marseille.

Annales De Chirurgie
|January 1, 1990
PubMed

Insights

Aortic graft infection is challenging. Early laparotomy is crucial for diagnosing secondary paraprosthetic fistula, even with negative tests, enabling timely in situ graft replacement.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Aortic graft infection poses significant challenges despite surgical and antimicrobial advancements.
  • Secondary paraprosthetic fistula is a rare but serious complication of aortic prostheses.

Observation:

  • A patient with an aortic prosthesis presented with unexplained infection, initially yielding negative complementary investigations.
  • Laparotomy was required for definitive diagnosis of a secondary paraprosthetic fistula.
  • Despite infection signs, in situ replacement of the infected aortic graft was performed.

Findings:

  • Organism-specific antibiotic therapy was crucial in managing postoperative septic shock.
  • Complementary investigations can be misleading in suspected aortic graft infections.

Implications:

  • Laparotomy should not be delayed in patients with aortic prostheses and unexplained infections.
  • Suspected graft infection warrants aggressive management, including early surgical intervention.
  • In situ graft replacement may be feasible even in the presence of active infection.

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