Fever + back / abdominal pain in patient with aortic graft, suspected graft infection
Recommended: CT Angiogram + FDG-PET/CT is the preferred imaging study for fever + back / abdominal pain in patient with aortic graft, suspected graft infection. Periaortic gas, fluid, soft tissue thickening, pseudoaneurysm, fistula.
Recommended study
CT Angiogram + FDG-PET/CT
Periaortic gas, fluid, soft tissue thickening, pseudoaneurysm, fistula. PET/CT for inflammatory activity.
If the default doesn't apply
Suspected aortoenteric fistula
CT
CT + EGD
IV contrast
Watch-outs
Aortoenteric fistula
GI bleed in patient with aortic graft → assume aortoenteric until proven otherwise; emergent imaging.
Pearls
- MAGIC criteria for vascular graft infection.
- Surgical management: graft excision + extra-anatomic bypass + prolonged antibiotics.
- Endovascular salvage techniques in selected patients.