Pelvic necrosis: a complication of infected aortic graft excision.
Infection is a devastating complication of synthetic aortic graft surgery. Patients with significant occlusive atherosclerosis of the internal iliac arteries undergoing aortic graft removal for graft infection may be at risk of pelvic and midbody necrosis. An unusual and fatal complication of this nature associated with the management of synthetic aortic graft infection has been encountered in two patients treated by extra-anatomic revascularization and staged removal of the infected aortic prosthesis. The hallmark of their presentation was pelvic and midbody necrosis in the presence of excellent distal perfusion with palpable pulses. Marginal pelvic circulation was therefore compromised further by graft removal and absence of retrograde pelvic perfusion. The finding of focal ischemic changes in the pelvic area of a patient with increasing serum creatinine phosphokinase activity, leukocytosis, myoglobinuria and paraplegia following infected aortic graft removal signals a grave and fatal prognosis.
Das
B M
BM
Department of Surgery, Grant Medical Center, Columbus, Ohio.
Zama
N
N
Satiani
B
B
Vaccaro
P S
PS
D000038:Abscess / Q000601:surgery; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D001161:Arteriosclerosis / Q000601:surgery; D001807:Blood Vessel Prosthesis; D017809:Fatal Outcome; D005734:Gangrene; D006083:Graft Occlusion, Vascular / Q000601:surgery; D006119:Groin / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009336:Necrosis; D010388:Pelvis / Q000098:blood supply*; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation
D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene