Stabilini L, Brigli G, La Paglia V, Bonomo A, Bisio M, Arnone G B, Romagnoli G L, Zanni N
Divisione di Chirurgia Generale, USSL 73-Ospedale S. Giacomo, Novi Ligure, Alessandria.
Minerva Chir. 1994 Oct;49(10):1019-23.
The authors report a case recently brought to their observation: T.A., a 77 year old patient, operated on in July 1990, for aortic aneurysm with axillo femoral by-pass. The patient was reoperated on the 5th day for ischaemic necrosis of the descending colon. In 1992 he was operated in another hospital for right iliac branch removal of the by-pass and performing of extra-anatomic bifemoral by-pass for right iliac branch infection of anatomic prosthesis. He was brought to our observation in March 1993, after the patient was refused in other Centres because of purulent abscess located near the aortic prosthesis and in the right iliac fossa, with a fistula to right superior anterior iliac crista. The patient was operated on in April 1993, with an explorative laparatomy to drain the abscess and to remove the aortic prosthesis. The aorta was sutured with closed bottom by means of delayed points. The postoperative course was regular and an arteriography performed three months after confirms the good running of the axillo-femoral by-pass and of the bifemoral one previously performed. The authors because of their experience and the bibliographical data underline the goodness of the axillo-femoral by-pass in serious infections of an aortic prosthesis.
T.A.，一名77岁患者，于1990年7月接受手术，治疗主动脉瘤并进行腋股旁路移植术。患者在术后第5天因降结肠缺血性坏死再次接受手术。1992年，他在另一家医院接受手术，切除旁路的右髂分支，并因解剖型假体的右髂分支感染进行解剖外双股旁路移植术。1993年3月，该患者因主动脉假体附近及右髂窝有脓性脓肿，且与右髂前上棘形成瘘管，在其他中心被拒收后转诊至我院。1993年4月，患者接受手术，行剖腹探查术以引流脓肿并取出主动脉假体。通过延迟缝合将主动脉底部封闭缝合。术后病程平稳，术后三个月进行的动脉造影证实腋股旁路移植术及先前进行的双股旁路移植术运行良好。作者根据自身经验及文献资料强调了腋股旁路移植术在主动脉假体严重感染中的优势。
