title: Inferior vena cava graft-enteric fistula after extended hepatectomy with caval replacement.
abstract: A case of an inferior vena cava (IVC) graft-enteric fistula manifesting with recurrent sepsis 11 years after a right hepatectomy extending to segments I and IV, the extrahepatic bile duct, and IVC followed by chemotherapy and external-beam radiation therapy is described. A preoperative workup revealed graft thrombosis with air bubbles inside the lumen. Laparotomy found a chronic fistula between the graft and the enteric biliary loop. Removal of the graft without further vascular reconstruction, a take-down of the biliary loop, and a redo hepaticojejunostomy were performed successfully. The diagnostic challenges, possible etiology, and therapeutic implications of this case are discussed.
authors.affiliation: Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasburg, France.
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D018810:Magnetic Resonance Angiography; D010690:Phlebography / Q000379:methods; D012008:Recurrence; D012086:Reoperation; D018805:Sepsis / Q000209:etiology; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*