Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease)
Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in
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| Veröffentlicht in: | Annals of vascular surgery 2012-02, Vol.26 (2), p.276.e1-276.e4 |
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| container_title | Annals of vascular surgery |
| container_volume | 26 |
| creator | Solomon, Brian Kim, Billy Rockman, Caron Veith, Frank J Jacobowitz, Glenn |
| description | Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in |
| doi_str_mv | 10.1016/j.avsg.2011.05.043 |
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They occur in <1% of aortic grafting procedures, result from graft defects, foreign bodies, and trauma, and are associated with a high mortality rate. We report a complex AEF associated with vertebral body osteomyelitis, likely secondary to tuberculous infection. A 78-year-old man presented with a 2-week history of abdominal pain, fever, and anemia. Past surgical history is significant for open repair of infrarenal abdominal aortic aneurysm followed later by an endovascular repair of a proximal para-anastomotic aneurysm. Computed tomography angiography revealed air in the aneurysm sac, without evidence of endoleak. The posterior aspect of the aneurysm was noted to be in continuity with a destructive osteomyelitis of the second lumbar vertebral body and an adjacent psoas abscess. Percutaneous drainage revealed purulent fluid containing mixed enteric flora. With fluoroscopic guidance, injection of contrast in the aortic sac drainage catheter demonstrated complex fistulous communications from the aortic sac to the overlying small intestine. After a course of drainage, antibiotic therapy, and parenteral nutrition, the patient underwent a transperitoneal repair of the AEF with duodeno-duodenectomy and wide debridement of the aortic sac and Dacron graft. Pathology revealed giant cell granulomas, highly suggestive of tuberculosis.</description><identifier>ISSN: 0890-5096</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1016/j.avsg.2011.05.043</identifier><identifier>PMID: 22304865</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Aged ; Anti-Bacterial Agents - therapeutic use ; Aortic Diseases - microbiology ; Aortic Diseases - therapy ; Blood Vessel Prosthesis - adverse effects ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - instrumentation ; Combined Modality Therapy ; Debridement ; Drainage ; Duodenal Diseases - microbiology ; Duodenal Diseases - therapy ; Granuloma, Giant Cell - microbiology ; Humans ; Intestinal Fistula - microbiology ; Intestinal Fistula - therapy ; Male ; Mycobacterium tuberculosis - isolation & purification ; Parenteral Nutrition ; Prosthesis-Related Infections - microbiology ; Prosthesis-Related Infections - therapy ; Reoperation ; Surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Tuberculin Test ; Tuberculosis, Spinal - complications ; Tuberculosis, Spinal - microbiology ; Vascular Fistula - microbiology ; Vascular Fistula - therapy</subject><ispartof>Annals of vascular surgery, 2012-02, Vol.26 (2), p.276.e1-276.e4</ispartof><rights>Annals of Vascular Surgery Inc.</rights><rights>2012 Annals of Vascular Surgery Inc.</rights><rights>Copyright © 2012 Annals of Vascular Surgery Inc. 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All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-6b3634acacaf7261ce7bbb113e90803bb7af9ad449094978b4c8a572d49e8dcd3</citedby><cites>FETCH-LOGICAL-c410t-6b3634acacaf7261ce7bbb113e90803bb7af9ad449094978b4c8a572d49e8dcd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.avsg.2011.05.043$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22304865$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Solomon, Brian</creatorcontrib><creatorcontrib>Kim, Billy</creatorcontrib><creatorcontrib>Rockman, Caron</creatorcontrib><creatorcontrib>Veith, Frank J</creatorcontrib><creatorcontrib>Jacobowitz, Glenn</creatorcontrib><title>Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease)</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in <1% of aortic grafting procedures, result from graft defects, foreign bodies, and trauma, and are associated with a high mortality rate. We report a complex AEF associated with vertebral body osteomyelitis, likely secondary to tuberculous infection. A 78-year-old man presented with a 2-week history of abdominal pain, fever, and anemia. Past surgical history is significant for open repair of infrarenal abdominal aortic aneurysm followed later by an endovascular repair of a proximal para-anastomotic aneurysm. Computed tomography angiography revealed air in the aneurysm sac, without evidence of endoleak. The posterior aspect of the aneurysm was noted to be in continuity with a destructive osteomyelitis of the second lumbar vertebral body and an adjacent psoas abscess. Percutaneous drainage revealed purulent fluid containing mixed enteric flora. With fluoroscopic guidance, injection of contrast in the aortic sac drainage catheter demonstrated complex fistulous communications from the aortic sac to the overlying small intestine. After a course of drainage, antibiotic therapy, and parenteral nutrition, the patient underwent a transperitoneal repair of the AEF with duodeno-duodenectomy and wide debridement of the aortic sac and Dacron graft. Pathology revealed giant cell granulomas, highly suggestive of tuberculosis.</description><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Aortic Diseases - microbiology</subject><subject>Aortic Diseases - therapy</subject><subject>Blood Vessel Prosthesis - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - instrumentation</subject><subject>Combined Modality Therapy</subject><subject>Debridement</subject><subject>Drainage</subject><subject>Duodenal Diseases - microbiology</subject><subject>Duodenal Diseases - therapy</subject><subject>Granuloma, Giant Cell - microbiology</subject><subject>Humans</subject><subject>Intestinal Fistula - microbiology</subject><subject>Intestinal Fistula - therapy</subject><subject>Male</subject><subject>Mycobacterium tuberculosis - isolation & purification</subject><subject>Parenteral Nutrition</subject><subject>Prosthesis-Related Infections - microbiology</subject><subject>Prosthesis-Related Infections - therapy</subject><subject>Reoperation</subject><subject>Surgery</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><subject>Tuberculin Test</subject><subject>Tuberculosis, Spinal - complications</subject><subject>Tuberculosis, Spinal - microbiology</subject><subject>Vascular Fistula - microbiology</subject><subject>Vascular Fistula - therapy</subject><issn>0890-5096</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1TAQhSMEoreFF2CBsitdJIwd58cSQrqUFioVFYm_peXYk-KQGxePUymvwFOT6F5YsECzsDT-zpFmziTJMwY5A1a97HN9T7c5B8ZyKHMQxYNkwypWZqUU9cNkA42ErARZHSXHRD0A441oHidHnBcgmqrcJL-2PkRn0ovR-tugu5hejR2a6PyYfnPxe7r-ezt5i6Me0ktHcRp0uiXyxumI9kDZXhscY_oVQ8Q2LOgbb-f0w2x8q03E4JbWDUX0uxkHFx2lLz76GE8pfesINeHZk-RRpwfCp4f3JPlyefH5_H12ffPu6nx7nRnBIGZVW1SF0GapruYVM1i3bctYgRIaKNq21p3UVggJUsi6aYVpdFlzKyQ21tjiJDnd-94F_3NCimrnyOAw6BH9REpy4AWTwBaS70kTPFHATt0Ft9NhVgzUGoHq1RqBWiNQUKolgkX0_GA_tTu0fyV_dr4Ar_YALkPeOwyKjMPRoHVh2byy3v3f__U_cjO40Rk9_MAZqfdTWJIixRRxBerTegTrDTAGUJa8KX4D7DevEA</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Solomon, Brian</creator><creator>Kim, Billy</creator><creator>Rockman, Caron</creator><creator>Veith, Frank J</creator><creator>Jacobowitz, Glenn</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120201</creationdate><title>Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease)</title><author>Solomon, Brian ; Kim, Billy ; Rockman, Caron ; Veith, Frank J ; Jacobowitz, Glenn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-6b3634acacaf7261ce7bbb113e90803bb7af9ad449094978b4c8a572d49e8dcd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Aortic Diseases - microbiology</topic><topic>Aortic Diseases - therapy</topic><topic>Blood Vessel Prosthesis - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - instrumentation</topic><topic>Combined Modality Therapy</topic><topic>Debridement</topic><topic>Drainage</topic><topic>Duodenal Diseases - microbiology</topic><topic>Duodenal Diseases - therapy</topic><topic>Granuloma, Giant Cell - microbiology</topic><topic>Humans</topic><topic>Intestinal Fistula - microbiology</topic><topic>Intestinal Fistula - therapy</topic><topic>Male</topic><topic>Mycobacterium tuberculosis - isolation & purification</topic><topic>Parenteral Nutrition</topic><topic>Prosthesis-Related Infections - microbiology</topic><topic>Prosthesis-Related Infections - therapy</topic><topic>Reoperation</topic><topic>Surgery</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><topic>Tuberculin Test</topic><topic>Tuberculosis, Spinal - complications</topic><topic>Tuberculosis, Spinal - microbiology</topic><topic>Vascular Fistula - microbiology</topic><topic>Vascular Fistula - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Solomon, Brian</creatorcontrib><creatorcontrib>Kim, Billy</creatorcontrib><creatorcontrib>Rockman, Caron</creatorcontrib><creatorcontrib>Veith, Frank J</creatorcontrib><creatorcontrib>Jacobowitz, Glenn</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Solomon, Brian</au><au>Kim, Billy</au><au>Rockman, Caron</au><au>Veith, Frank J</au><au>Jacobowitz, Glenn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease)</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>26</volume><issue>2</issue><spage>276.e1</spage><epage>276.e4</epage><pages>276.e1-276.e4</pages><issn>0890-5096</issn><eissn>1615-5947</eissn><abstract>Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in <1% of aortic grafting procedures, result from graft defects, foreign bodies, and trauma, and are associated with a high mortality rate. We report a complex AEF associated with vertebral body osteomyelitis, likely secondary to tuberculous infection. A 78-year-old man presented with a 2-week history of abdominal pain, fever, and anemia. Past surgical history is significant for open repair of infrarenal abdominal aortic aneurysm followed later by an endovascular repair of a proximal para-anastomotic aneurysm. Computed tomography angiography revealed air in the aneurysm sac, without evidence of endoleak. The posterior aspect of the aneurysm was noted to be in continuity with a destructive osteomyelitis of the second lumbar vertebral body and an adjacent psoas abscess. Percutaneous drainage revealed purulent fluid containing mixed enteric flora. With fluoroscopic guidance, injection of contrast in the aortic sac drainage catheter demonstrated complex fistulous communications from the aortic sac to the overlying small intestine. After a course of drainage, antibiotic therapy, and parenteral nutrition, the patient underwent a transperitoneal repair of the AEF with duodeno-duodenectomy and wide debridement of the aortic sac and Dacron graft. Pathology revealed giant cell granulomas, highly suggestive of tuberculosis.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>22304865</pmid><doi>10.1016/j.avsg.2011.05.043</doi></addata></record> |
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| subjects | Aged Anti-Bacterial Agents - therapeutic use Aortic Diseases - microbiology Aortic Diseases - therapy Blood Vessel Prosthesis - adverse effects Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - instrumentation Combined Modality Therapy Debridement Drainage Duodenal Diseases - microbiology Duodenal Diseases - therapy Granuloma, Giant Cell - microbiology Humans Intestinal Fistula - microbiology Intestinal Fistula - therapy Male Mycobacterium tuberculosis - isolation & purification Parenteral Nutrition Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - therapy Reoperation Surgery Tomography, X-Ray Computed Treatment Outcome Tuberculin Test Tuberculosis, Spinal - complications Tuberculosis, Spinal - microbiology Vascular Fistula - microbiology Vascular Fistula - therapy |
| title | Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease) |
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