Recurrent lower limb abscesses as the primary manifestation of aorto-femoral graft paraprosthetic fistula.
A 62-year-old man was presented to our facility with recurrent right lower limb abscesses. He had an aortobifemoral graft for an aortoiliac occlusive disease. The diagnosis of paraprosthetic fistula was confirmed by performing a high-resolution contrast-enhanced computed tomography, whereas labeled leukocyte imaging provided a negative result. The graft present in the right limb was removed and extra-anatomical femoro-femoral bypass was performed along with segmental ileal resection of the affected loop and a side-to-side anastomosis. Recovery was unremarkable, with no recurrence of abscess 18 months after surgery. To our knowledge, this is the first report in published data on a paraprosthetic fistula presenting as recurrent lower limb abscesses. In this article, we have discussed the clinical features, principal diagnostic findings, and therapeutic options.
Department of Cardiovascular and Thoracic Surgery, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon. majdi.elhusseiny@gmail.com
Majdi
M
El Husseiny
Lamisse
L
Karam
Georges
G
Tabet
Victor
V
Jebara
Jacques
J
Choucair
D000038:Abscess / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D001011:Aorta / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D016971:Citrobacter freundii / Q000302:isolation & purification; D020878:Device Removal; D013505:Digestive System Surgical Procedures; D004754:Enterobacter / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020613:Morganella morganii / Q000302:isolation & purification; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D014656:Vascular Surgical Procedures