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Rectal fistula induced artificial vascular graft infection: A case report
Honghua Zhou1, Kanghui Dai2, Zhinan Ju2
1Department of General Surgery, Jiujiang University Affiliated Hospital, Jiujiang, Jiangxi, China.
Rationale:
Artificial vascular graft infection (AVGI) is a rare but severe complication in vascular surgery, often associated with high morbidity and mortality. This case report highlights a unique instance of AVGI caused by a rectal fistula, emphasizing the diagnostic challenges and management strategies in such a rare scenario.
Patient Concerns:
A 60-year-old female presented with low-grade fever and purulent discharge from an abdominal incision 1 year after antibiotic therapy had failed to resolve the infection. She had a history of aortofemoral dacron graft bypass 6 years prior, complicated by a rectal hematoma due to trauma.
Diagnoses:
The patient was diagnosed with a rectal fistula, AVGI, and perivascular sinus formation. Diagnostic workup revealed the presence of Escherichia coli infection.
Interventions:
The patient underwent graft excision and debridement. No vascular reconstruction was necessary due to the presence of sufficient collateral circulation. This intervention was performed following the failure of conservative antibiotic therapy.
Outcomes:
Postoperative recovery was uneventful, with normalization of inflammatory markers and no signs of limb ischemia upon follow-up. The patient's symptoms resolved without complications.
Lessons:
This case underscores the importance of early diagnosis using imaging, particularly in patients with vascular prosthetic grafts who may have adjacent organ injuries such as a rectal fistula. It also highlights the need for tailored surgical approaches and the significance of regular follow-up in managing AVGI.
