Pancreatic Abscess Involving the Aortic Graft Following Repair of a Ruptured Aortic Aneurysm: Successful Replacement with Femoro-popliteal Vein

Abstract

Acute pancreatitis is a rare complication after aortic surgery and carries a high mortality. We report the successful management of an infected aortic graft secondary to complicated severe pancreatitis in a 77-year-old man by open drainage of the abscess and replacement of the prosthetic graft with superficial femoro-popliteal vein (SFPV). The patient remains free from infection with a patent graft 8 months later.

Huge infra renal abdominal aortic aneurysm presented with concomitant divirticular abscess: A case report

“…In both of these conditions, there is an urgent need of operation. 5 In the following case report, the abnormal presentation of a huge AAA associated with a divirticular abscess requires the surgical treatment and there are not any similar cases in literature.…”

A 10-year Experience of Using Femoro-popliteal Vein for Re-vascularisation in Graft and Arterial Infections

“…Another, who presented with an infected aortic tube graft communicating with a pancreatic abscess, required a cystogastrostomy and drainage of multiple intra-abdominal abscesses. 23…”

Infected pancreatic necrosis after extraperitoneal abdominal aortic aneurysm repair: Report of a case

“…4 The mortality associated with minor AP in vascular patients is 10%, 1,3 but complications resulted in a worse prognosis in almost 100% of patients because of sepsis and multiorgan failure secondary to the pancreatic abscess. [1][2][3][4][5][6] Our patient suffered a sudden intraoperative cardiac arrest and the prolonged hypoperfusion was probably the main cause of his pancreatic ischemia, with subsequent aseptic necrosis. The extraperitoneal retrorenal access to the aorta could have been an adjunctive risk because medial displacement of the pancreatic body and tail increases the hazards of direct mechanical trauma, although we have never before encountered this complication when using this approach.…”

“…[1][2][3][4][5][6] The clinical symptoms can be vague and nonspecifi c, and the diagnosis is often delayed, if not made at autopsy. Although most cases of postoperative AP are mild or even subclinical, extensive pancreatic necrosis, possibly infected, poses a formidable challenge to the surgeon, who is faced with the dilemma of the pancreatic abscess requiring drainage and the high risk of concomitant or subsequent prosthetic infection.…”