Retroperitoneal fibrosis and infection of an aortic graft prosthesis: diagnosis and therapeutic problems

Area of Science:

• Vascular Surgery
• Radiology
• Infectious Disease

Background:

• Aorto-bifemoral bypass is a common surgical procedure for lower limb ischemia.
• Retroperitoneal fibrosis (RPF) is an uncommon complication post-bypass surgery.
• Graft prosthesis infection can lead to serious complications.

Observation:

• This report details a rare case of RPF occurring after an aorto-bifemoral bypass.
• The RPF was identified as a complication stemming from an infected graft prosthesis.
• Diagnostic imaging modalities were employed to investigate the complication.

Findings:

• Computed tomography (CT) and magnetic resonance imaging (MRI) are valuable tools for diagnosing graft infections.
• These imaging techniques can detect signs such as periprosthetic gas or persistent perigraft fluid.
• However, imaging performed too early in the post-operative period may yield false negatives, suggesting the need for repeat scans.

Implications:

• Early and accurate diagnosis of graft infection is crucial for effective patient management.
• The findings highlight the importance of considering RPF in patients with unexplained symptoms post-bypass.
• Repeat imaging may be necessary to confirm or rule out graft infection when initial scans are equivocal.