Secondary Aortoenteric Erosion Followed by Recurrent Lower Extremity Abscesses.
A secondary aortoenteric fistula (SAEF) is a relatively rare complication of aortoiliac reconstructive surgery, often involving relatively fixed duodenal third portion and a vascular anastomosis. We observed a 52-year-old man with a recurrent right lower leg abscess following the erosion between ipsilateral bifurcated prosthetic graft limb and nonfixed jejunum. In situ graft-sparing surgical treatment with aggressive debridement was successfully performed. A SAEF may occur even at a nonvascular anastomosis site, or in nonfixed small bowel, and may become a source of a septic embolus. A high index of suspicion for SAEF is required for early diagnosis and treatment of this life-threatening complication.
Department of Vascular Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan. Electronic address: shigeshi.ono81@gmail.com.
Shigeshi
S
Ono
Department of Vascular Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan.
Yoshitomo
Y
Samejima
Department of Vascular Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan.
Susumu
S
Watada
Department of Vascular Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan.
Toshihiro
T
Kakefuda
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D001062:Appendectomy; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D003646:Debridement; D020878:Device Removal; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007579:Jejunal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery
D000900:Anti-Bacterial Agents