A Case of Aortic Prosthetic Graft Infection Treated with Computed Tomography-guided Drainage

Abstract

Prosthetic graft infection after abdominal aneurysm surgery is a fatal complication. The recommended treatment is surgical removal of the infected graft; however, this treatment is invasive. A 65-year-old man who had undergone open graft replacement for a common iliac artery and aortic aneurysm. Two months after the surgery, the patient visited our hospital with pyrexia. The level of inflammatory reaction was elevated. Enhanced computed tomography (CT) showed enlargement of the perigraft aneurysmal sac and an increased density of the surrounding fat tissue. Based on these findings, the patient was diagnosed with prosthetic graft infection. Antibiotic therapy was initiated. On the fifth day after admission, enlargement of the site was observed on CT. CT-guided puncture and closed drainage of the fluid collection around the prosthetic graft were performed. A discharge of white pus was observed. The pyrexia resolved the next day, and the drain was removed on the seventh day after the puncture. Methicillin-susceptible Staphylococcus aureus was detected in the aspirated pus. The patient’s treatment was switched to oral antibiotics and was discharged on the 38th day after admission. The patient has had no relapse for 10 months, after the CT-guided drainage. CT-guided drainage is a minimally invasive technique that is useful for both detecting causative microorganisms and treatment in patients with prosthetic graft infection. Clinicians might consider using this treatment strategy when treating prosthetic graft infection after abdominal aneurysm surgery.