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      Perigraft air mimicking infection on CT angiography following open abdominal aortic aneurysm repair

      case-report
      , MD * , , MD, PhD, , MD
      Radiology Case Reports
      Elsevier
      Perigraft air, Aortic graft infection

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          Abstract

          Aortic graft infection is a feared complication after open abdominal aortic aneurysm repair secondary to its high mortality. Perigraft air is a common finding after open aortic aneurysm repair; however, it is also associated with aortic graft infection. Delineating between graft infection and common postoperative finding is a challenge. This is further complicated by use of hemostatic agents such as Gelfoam, which is also documented to cause perigraft air. Correct diagnosis has crucial implications in management of potential aortic graft infection, which is a vascular emergency. We report a case of perigraft air in a patient status after open aortic aneurysm repair with associated clinical manifestations of infection in whom conservative management and surveillance was selected for treatment. We then discuss the timeline of perigraft air, potential causation, importance of history, and physical examination, and finally, we discuss how specific findings on computed tomography imaging for infection in other areas may be useful in aortic graft infection.

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          FDG-PET in prosthetic graft infections.

          Graft infection following prosthetic vascular reconstruction is an uncommon but severe complication. The clinical presentation is often subtle and nonspecific and may occur long after surgery. Although defining a prosthetic vascular graft infection can be difficult, early diagnosis and treatment are essential for the correct choice of treatment to prevent further complications as well as the high morbidity and mortality associated with repeat surgery and removal of infected grafts. False-positive results may lead to unnecessary surgery while failure to diagnose graft infection may have life-threatening sequels. Scarce literature that is currently available regarding the role of (18)F-labeled fluorodeoxyglucose imaging for assessment of vascular graft infection suggests that this modality may represent reliable noninvasive imaging modality in this specific clinical setting. PET/CT increases the test specificity and thus improves diagnostic accuracy. The precise anatomic localization of increased (18)F-labeled fluorodeoxyglucose PET/CT enables accurate differentiation between graft and adjacent soft tissue infection leading to more accurate diagnosis and subsequent optimized therapeutic strategy.
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            Distinguishing gelatin bioabsorbable sponge and postoperative abdominal abscess on CT.

            The objective of our study was to differentiate the CT findings of gelatin bioabsorbable sponges used as hemostatic agents from postoperative abdominal abscess. Gelatin absorbable sponge may mimic a postoperative abscess on CT. Findings that may help differentiate the hemostatic agent from abscess include linear arrangement of tightly packed gas bubbles, fixed position of gas bubbles on subsequent examinations, shape, lack of air-fluid level, and lack of enhancing wall.
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              Endovascular management of arterioenteric fistulas: a systemic review and meta-analysis of the literature.

              To present a systemic review and meta-analysis investigating the outcomes of endovascular management of arterioenteric fistula (AEF).
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                Author and article information

                Contributors
                Journal
                Radiol Case Rep
                Radiol Case Rep
                Radiology Case Reports
                Elsevier
                1930-0433
                03 February 2018
                April 2018
                03 February 2018
                : 13
                : 2
                : 343-346
                Affiliations
                Banner University Medical Center-University of Arizona, Tucson, AZ 85724-5072, USA
                Author notes
                [* ]Corresponding author. bradtrinidad@ 123456gmail.com
                Article
                S1930-0433(17)30577-0
                10.1016/j.radcr.2018.01.020
                6000158
                a8ac44f9-2fbd-426f-a170-34f8be56dd47
                © 2018 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 26 November 2017
                : 6 January 2018
                Categories
                Complications of Therapy

                perigraft air,aortic graft infection
                perigraft air, aortic graft infection

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