Slieker Fons J B, Ruurda Jelle P, Hazenberg Constantijn E V B
Department of Vascular Surgery, UMC, Utrecht, the Netherlands.
Department of Gastrointestinal and Oncologic Surgery, UMC, Utrecht, the Netherlands.
Ann Vasc Surg. 2019 Aug;59:314.e1-314.e4. doi: 10.1016/j.avsg.2019.02.011. Epub 2019 Apr 19.
Secondary stent graft infection is a life-threatening complication after thoracic endovascular aortic repair (TEVAR). There is no consensus on optimal treatment strategy, but combined antibiotic and surgical treatment is advocated. Two years after his TEVAR procedure, a 70-year-old patient was admitted to the hospital with a secondary periaortic abscess. At first, the abscess was managed with clindamycin and transesophageal drainage. The abscess would not dissipate, and an infected iatrogenic aortoesophageal fistula was formed, which was surgically treated with esophageal resection, gastric tube reconstruction, and omental flap coverage.
继发性支架移植物感染是胸主动脉腔内修复术（TEVAR）后一种危及生命的并发症。对于最佳治疗策略尚无共识，但提倡联合使用抗生素和手术治疗。在接受TEVAR手术后两年，一名70岁患者因继发性主动脉周围脓肿入院。起初，脓肿采用克林霉素和经食管引流进行处理。脓肿未消退，形成了感染性医源性主动脉食管瘘，遂通过食管切除、胃管重建和网膜瓣覆盖进行手术治疗。
