Trinidad Bradley, Weinkauf Craig, Hughes John
Banner University Medical Center-University of Arizona, Tucson, AZ 85724-5072, USA.
Radiol Case Rep. 2018 Feb 3;13(2):343-346. doi: 10.1016/j.radcr.2018.01.020. eCollection 2018 Apr.
Aortic graft infection is a feared complication after open abdominal aortic aneurysm repair secondary to its high mortality. Perigraft air is a common finding after open aortic aneurysm repair; however, it is also associated with aortic graft infection. Delineating between graft infection and common postoperative finding is a challenge. This is further complicated by use of hemostatic agents such as Gelfoam, which is also documented to cause perigraft air. Correct diagnosis has crucial implications in management of potential aortic graft infection, which is a vascular emergency. We report a case of perigraft air in a patient status after open aortic aneurysm repair with associated clinical manifestations of infection in whom conservative management and surveillance was selected for treatment. We then discuss the timeline of perigraft air, potential causation, importance of history, and physical examination, and finally, we discuss how specific findings on computed tomography imaging for infection in other areas may be useful in aortic graft infection.
主动脉移植物感染是开放腹主动脉瘤修复术后令人担忧的并发症，因其死亡率高。移植物周围积气是开放主动脉瘤修复术后常见的表现；然而，它也与主动脉移植物感染有关。区分移植物感染和常见的术后表现是一项挑战。使用止血剂（如明胶海绵）会使情况更加复杂，明胶海绵也被记录可导致移植物周围积气。正确诊断对潜在主动脉移植物感染的管理至关重要，这是一种血管急症。我们报告一例开放主动脉瘤修复术后患者出现移植物周围积气，并伴有感染的临床表现，该患者选择了保守治疗和监测。然后我们讨论移植物周围积气的时间线、潜在病因、病史和体格检查的重要性，最后，我们讨论计算机断层扫描成像上其他部位感染的特定表现如何有助于诊断主动脉移植物感染。
