Related Experiment Videos
[Periaortitis following endovascular aortic repair]
Mike J L Peters1, Michiel H van Werkum, Willem Wisselink
1VUmc, Amsterdam.
Nederlands Tijdschrift Voor Geneeskunde
|September 12, 2013
Summary
Fever after endovascular aortic repair (EVAR) may signal sterile periaortitis, not infection. Prompt diagnosis and glucocorticoid treatment can resolve symptoms and prevent complications.
Area of Science:
- Vascular Surgery
- Inflammatory Diseases
- Medical Imaging
Background:
- Fever post-endovascular prosthesis implantation often suggests infection.
- Periaortitis, a sterile inflammatory reaction, can mimic infection around the arterial wall.
Observation:
- An 81-year-old male presented with fever and back pain one year after EVAR.
- PET-CT indicated infection, but microbiological tests were negative.
- Inflammation spread, causing renal dysfunction and hydronephrosis, diagnosed as periaortitis.
Findings:
- Periaortitis is a rare complication of EVAR, presenting symptoms similar to infection.
- Negative microbiological investigations are crucial for distinguishing periaortitis from infection.
- Glucocorticoid therapy effectively resolved periaortitis symptoms and improved renal function.
Implications:
- Accurate differentiation between EVAR infection and periaortitis is critical for appropriate therapeutic strategy.
- Timely diagnosis of periaortitis can prevent severe complications like renal failure.
- This case highlights the importance of considering sterile inflammatory reactions in post-EVAR fever.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:18Endocarditis III: Medical Management
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:29Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
01:25Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...