ABSTRACT
BACKGROUND: Prosthetic vascular graft procedures are a common treatment modality for peripheral vascular disease. A relatively common complication is graft infection, occurring at a rate of 0.5-5%. When they occur, graft infections are associated with significant morbidity and mortality. Vascular graft infections also represent a diagnostic and therapeutic challenge for the physician METHODS: Here, we report a case where the rare finding of secondary hypertrophic osteoarthropathy was an important indication of underlying aortic graft infection that was initially misdiagnosed. A review of the literature revealed 34 cases of vascular graft infection associated with hypertrophic osteoarthropathy. RESULTS: The mean interval from surgery to time of infection was approximately 5 years. Mortality was 35%. When combined with hypertrophic osteoarthropathy, vascular graft infection was complicated by an aortoenteric fistula in 53% of the cases. CONCLUSION: The complexity of this case highlights the challenges physicians face in order to diagnose and treat this condition.
Subject(s)
Aorta/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Blood Vessel Prosthesis Implantation/instrumentation , Blood Vessel Prosthesis/adverse effects , Femoral Artery/surgery , Osteoarthropathy, Secondary Hypertrophic/diagnosis , Peripheral Arterial Disease/surgery , Prosthesis-Related Infections/diagnosis , Adolescent , Adult , Aged , Device Removal , Diagnostic Errors , Fatal Outcome , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Osteoarthropathy, Secondary Hypertrophic/diagnostic imaging , Osteoarthropathy, Secondary Hypertrophic/microbiology , Osteoarthropathy, Secondary Hypertrophic/surgery , Predictive Value of Tests , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/microbiology , Prosthesis-Related Infections/surgery , Treatment OutcomeABSTRACT
Hypertrophic Osteoarthropathy is classically associated with chronic pulmonary disease, cancer or inflammatory bowel disease. However, deep infection such as vascular graft infection is an etiology important to recognize because of the risk of life-threatening complication (aorto-enteric fistula). In this study, we reported two cases of aortic graft infection and one case of para-anal abscess associated with hypertrophic osteoarthropathy. The previously reported cases are reviewed.