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[Evaluation of various diagnostic methods in aortic-iliac graft infection]
P Gutowski1, G Szumiłowicz, M Cnotliwy
1Kliniki Chirurgii Ogólnej i Naczyniowej Pomorskiej Akademii Medycznej w Szczecinie.
Abstract:
Aortoenteric anastomotic fistulae and paraprosthetic aortic-iliac graft infections are rare but devastating and potentially lethal complication of aortic graft surgery. Although the incidence of these complications is reported to be less then 1-4%, the difficulty in diagnosis and management has led to high mortality rates and extensive morbidity. In our opinion computed tomography, 99m Tc-HM-PAO-labeled white blood cell scan and upper GI tract endoscopy are a most useful adjuncts to the diagnosis of all types of aortic graft infection, like paraprosthetic-enteric fistula or graft infection without intestinal communication.
Insights
Diagnosing rare but serious aortic graft infections, including aortoenteric fistulae, is challenging. Advanced imaging like CT scans and labeled white blood cell scans, alongside endoscopy, aid in identifying these graft complications.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Infectious Diseases
Background:
- Aortoenteric fistulae and paraprosthetic aortic-iliac graft infections are rare but severe complications of aortic graft surgery.
- These infections, though infrequent (1-4%), present diagnostic and management challenges, leading to high mortality and morbidity.
Purpose of the Study:
- To highlight the diagnostic utility of specific imaging modalities for aortic graft infections.
- To emphasize the importance of early and accurate diagnosis in managing these potentially lethal complications.
Main Methods:
- Review of diagnostic approaches for aortic graft infections.
- Utilizing computed tomography (CT) scans.
- Employing 99m Tc-HM-PAO-labeled white blood cell scans.
- Performing upper gastrointestinal (GI) tract endoscopy.
Main Results:
- CT scans, labeled white blood cell scans, and upper GI endoscopy are valuable tools for diagnosing aortic graft infections.
- These methods assist in identifying both paraprosthetic-enteric fistulas and graft infections without intestinal communication.
Conclusions:
- A combination of advanced imaging and endoscopy is crucial for the diagnosis of aortic graft infections.
- Prompt diagnosis through these adjuncts can potentially improve patient outcomes and reduce mortality associated with these rare complications.