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      Perforación sigmoidea iatrogénica por prótesis vascular durante un bypass aortobifemoral Translated title: Iatrogenic sigmoid perforation by vascular prosthesis during aortobifemoral bypass

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          Abstract

          Resumen Introducción: las fístulas aortoentéricas (FAE) son una grave complicación en el campo de la cirugía vascular con una morbimortalidad muy elevada. Caso clínico: mujer de 58 años con antecedente de cirugía y radioterapia pélvica por cáncer de cérvix que es intervenida por síndrome de Leriche. Se realiza bypass aortobifemoral con desarrollo de FAE secundaria a la perforación iatrogénica del sigma durante la tunelización de la prótesis. Requiere de dos reintervenciones, múltiples antibióticos y un largo posoperatorio para resolver las secuelas. Discusión: el diagnóstico de la FAE requiere un alto nivel de sospecha y su manejo debe ser agresivo de entrada dada la morbimortalidad que se asocia a esta complicación. El antecedente de radioterapia pélvica ha favorecido este hecho y su tratamiento multidisciplinar es indispensable para la resolución del cuadro.

          Translated abstract

          Abstract Introduction: aortoenteric fistulas (AEF) are a serious complication in the field of vascular surgery with a very high morbimortality. Case report: 58-year-old woman with a history of surgery and pelvic radiotherapy for cervical cancer who is undergoing surgery for Leriche syndrome. Aortobifemoral bypass is performed with the development of AEFs secondary to iatrogenic perforation of the sigma during tunneling of the prosthesis. The patient requires two reinterventions, many antibiotics and a long postoperative period to resolve the sequelae. Discusion: the diagnosis of AEF requires a high level of suspicion and its management must be aggressive from the outset given the morbidity and mortality associated with this complication. The history of pelvic radiotherapy has favoured this fact and its multidisciplinary treatment is essential for the resolution of this problem.

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          Most cited references8

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          Diagnosis of Aortic Graft Infection: A Case Definition by the Management of Aortic Graft Infection Collaboration (MAGIC).

          The management of aortic graft infection (AGI) is highly complex and in the absence of a universally accepted case definition and evidence-based guidelines, clinical approaches and outcomes vary widely. The objective was to define precise criteria for diagnosing AGI.
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            Current Evidence on Management of Aortic Stent-graft Infection: A Systematic Review and Meta-Analysis

            Aortic stent-graft infection (SGI) is rare but remains one of the most challenging and threatening complications. This systematic review aimed to identify the clinical features, treatment, and outcomes of endograft infection after abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR).
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              Diagnostic performance of 18F-FDG-PET/CT in vascular graft infections.

              The aim of this study was to evaluate the diagnostic accuracy of positron emission tomography/computed tomography with (18)F-fludeoxyglucose (FDG-PET/CT) in a population with suspected graft infection and to validate a new diagnostic imaging score for FDG-PET/CT.
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                Author and article information

                Journal
                angiologia
                Angiología
                Angiología
                Arán Ediciones S.L. (Madrid, Madrid, Spain )
                0003-3170
                1695-2987
                April 2021
                : 73
                : 2
                : 91-94
                Affiliations
                [1] Tenerife orgnameHospital Universitario Nuestra Señora de Candelaria orgdiv1Servicio de Cirugía General y del Aparato Digestivo España
                Article
                S0003-31702021000200008 S0003-3170(21)07300200008
                10.20960/angiologia.00225
                d3728ce5-47c5-4641-83f1-de883a74ba69

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 29 October 2020
                : 24 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 4
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                Colon sigmoide,Prosthesis,Colon-sigmoid,Intestinal perforation,Prótesis vascular,Perforación intestinal

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