Infected abdominal aortic aneurysm endovascular stent

Case contributed by Dr Sachintha Hapugoda

Presentation

Presyncopal event two months post endovascular aortic aneurysm repair for 9cm AAA. Hypotensive with abdominal tenderness. Serum inflammatory markers raised on admission.

Patient Data

Age: 65 years
Gender: Female

CT Abdomen+Pelvis

CT

There is circumferential retroperitoneal inflammation surrounding the repaired aorta. Gas locules present within aneurysmal sac.  Reactive appearing lymph nodes are also present. No evidence of endoleak. Findings are consistent with graft infection.

White Blood Cell Scan

Nuclear medicine

There is abnormal white cell accumulation surrounding the aortic graft, mostly at the level of the bifurcation and the right iliac limb. Findings are consistent with graft infection.

Case Discussion

Abdominal tenderness partly improved over admission with IV antibiotic therapy. 

Arrangements made for operative repair as infection deemed unlikely to resolve with conservative management.

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