Voiriot P, Duperval R, Teijeira J, Lévesque R, Lambert R
Rev Infect Dis. 1987 Mar-Apr;9(2):376-81. doi: 10.1093/clinids/9.2.376.
The case of a 73-year-old man with localized left-lower-limb hypertrophic osteoarthropathy in association with aortic left-iliac-artery bypass and enteroprosthetic fistula was studied. The patient presented first with massive gastrointestinal bleeding and with pain and swelling of his left leg. He was hospitalized on numerous occasions for recurrent episodes of bacteremia involving enteric flora; hypertrophic osteoarthropathy and aortoduodenal fistula were documented before surgery. Symptoms and signs of hypertrophic osteoarthropathy were markedly alleviated after removal of the infected prosthesis. A review of the literature revealed seven additional patients with a similar presentation. The diagnosis of infected arterial graft with enteroprosthetic fistula may be extremely difficult, and a delay in this diagnosis may be lethal. Awareness of this uncommon association may lead to prompt diagnosis and early surgical therapy.
研究了一名73岁男性病例，其患有局限性左下肢肥厚性骨关节病，伴有主动脉左髂动脉搭桥术和肠内假体瘘。患者最初表现为大量胃肠道出血以及左腿疼痛和肿胀。他因涉及肠道菌群的反复菌血症发作多次住院；术前记录有肥厚性骨关节病和主动脉十二指肠瘘。移除感染的假体后，肥厚性骨关节病的症状和体征明显缓解。文献回顾发现另外7例有类似表现的患者。感染性动脉移植物合并肠内假体瘘的诊断可能极其困难，诊断延迟可能致命。认识到这种不常见的关联可能有助于及时诊断和早期手术治疗。
