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Related Experiment Videos

Aorto-enteric fistula presenting as multicentric osteomyelitis.

S L Gordon, G G Nicholas, S L Carter

    Clinical Orthopaedics and Related Research
    |March 1, 1978
    PubMed
    Summary

    Aorto-enteric fistulae, often linked to vascular surgery prostheses, can lead to delayed diagnosis of multicentric osteomyelitis. Early detection is crucial to prevent fatal bacteremia and septicemia.

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    Area of Science:

    • Vascular Surgery
    • Infectious Diseases
    • Orthopedic Surgery

    Background:

    • Aorto-enteric fistulae (AEF) are abnormal connections between the aorta and the gastrointestinal tract.
    • AEF incidence has increased with the widespread use of prosthetic materials in vascular reconstructive surgery.
    • These fistulae can arise from various causes, including infection, inflammation, or surgical complications.

    Observation:

    • A 60-year-old male patient presented with multicentric osteomyelitis.
    • The patient had a history of prosthetic repair for aorto-enteric fistulae.
    • Enteric flora were identified in blood and bone cultures, indicating a deep-seated infection.

    Findings:

    • The diagnosis of osteomyelitis was significantly delayed despite positive cultures.

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  • Multicentric osteomyelitis developed as a complication in a patient with a history of AEF and prosthetic material.
  • The clinical presentation of AEF can be insidious, not always dramatic.

    • Implications:

    • Delayed diagnosis of AEF-related complications like osteomyelitis can lead to severe outcomes, including fatal bacteremia and septicemia.
    • Vigilance for infectious complications is essential in patients with vascular prostheses, particularly those with a history of AEF.
    • Improved diagnostic strategies and timely intervention are critical for managing AEF and its sequelae.