Chung Chris Tae Young, Min Sangil, Min Seung-Kee
Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Vasc Specialist Int. 2021 Jun 28;37:16. doi: 10.5758/vsi.210036.
A 62-year-old male with a history of femoro-femoral crossover bypass surgery 31 months previously presented with recurrent symptoms of fever and chills, along with a previous positive blood culture. Computed tomography showed vegetation in the bypass graft located in the peritoneal cavity, closely abutting the small bowel and soft tissue lesions in the right proximal thigh and distal calf. Under high suspicion of graft-enteric fistula with metastatic infection, surgery was performed to remove the previous graft and insert a new femoro-femoral bypass graft subcutaneously. Small bowel resection and anastomosis were also performed because the graft penetrated the small bowel mesentery and eroded into the small bowel. The patient had a patent graft without infection for more than 10 years. This case demonstrates the importance of tunneling in femoro-femoral crossover bypass free from the small bowel or other intraperitoneal organs.
一名62岁男性，31个月前接受过股-股交叉搭桥手术，现出现反复发热和寒战症状，之前血培养呈阳性。计算机断层扫描显示，位于腹腔的搭桥移植物中有赘生物，紧邻小肠，右大腿近端和小腿远端有软组织病变。高度怀疑为伴有转移性感染的移植物-肠瘘，遂进行手术，切除先前的移植物，并皮下植入新的股-股交叉搭桥移植物。由于移植物穿透小肠系膜并侵蚀小肠，还进行了小肠切除和吻合术。该患者的移植物通畅且无感染超过10年。本病例表明了股-股交叉搭桥术中避开小肠或其他腹腔内器官进行隧道化操作的重要性。
