title: [Periaortitis following endovascular aortic repair].
abstract: BACKGROUND
  Infection is the most obvious cause of fever following implantation of an endovascular prosthesis; however, fever and inflammation around the arterial wall can also be caused by a sterile inflammatory reaction: periaortitis.
  
  
  METHODS
  An 81-year-old man was referred because of fever and back pain. He had undergone an endovascular aortic repair (EVAR) 1 year earlier; an endovascular prosthesis had been placed during this procedure, to repair an abdominal aortic aneurysm. A positive emission tomography (PET)-CT scan revealed uptake of 18F-fluorodeoxyglucose around the endovascular prosthesis, consistent with infection; however, intensive microbiological investigation, including biopsy from the site of the endovascular prosthesis, revealed no micro-organisms. Empirical administration of antibiotics had no effect. Decreased renal function occurred approximately 4 weeks later, and a CT scan revealed spread of the inflammatory process accompanied by hydronephrosis, consistent with periaortitis. Following treatment with glucocorticoids, renal function returned to normal and the symptoms disappeared.
  
  
  CONCLUSIONS
  Periaortitis is a rare, late complication of an EVAR. Clinical presentation can closely resemble an infection, while distinguishing infection from (sterile) periaortitis is important for the choice of treatment.
authors.affiliation: VUmc, Amsterdam.
authors.forename: Mike J L
authors.initials: MJ
authors.lastname: Peters
authors.forename: Michiel H
authors.initials: MH
authors.lastname: van Werkum
authors.forename: Willem
authors.initials: W
authors.lastname: Wisselink
authors.forename: Merel
authors.initials: M
authors.lastname: van Andel
authors.forename: Herman M
authors.initials: HM
authors.lastname: Hofstee
authors.forename: Marije K
authors.initials: MK
authors.lastname: Bomers
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D011877:Radionuclide Imaging; D012185:Retroperitoneal Fibrosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
chemical_list: D019788:Fluorodeoxyglucose F18