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Case Reports
. 2019 Oct 31;14(12):1558-1560.
doi: 10.1016/j.radcr.2019.09.033. eCollection 2019 Dec.

Air within surgical arterial graft on computed tomography-An alarming finding of a rare complication

Vardhan S Joshi  1 , Advait Kothurkar  2 , Kourabhi Banode  1 , Sanjay Kolte  3
Affiliations
Case Reports

Air within surgical arterial graft on computed tomography-An alarming finding of a rare complication

Vardhan S Joshi et al. Radiol Case Rep. .

Abstract

We present a case of a 61 years old lady operated 2 years back for severe superior mesenteric artery stenosis with a surgical vascular graft and presenting as acute severe abdominal pain and vomiting. Her CT angiography showed occlusion of the surgical vascular graft with graft migration into small bowel. Both the findings of graft occlusion and bowel perforation were optimally demonstrated on the CT angiography study. The alarm of bowel perforation in addition to graft infection was raised by the presence of air pockets within the graft and its communication with bowel lumen. Coexistent graft infection was evident on graft culture.

Keywords: Air; CIA, common iliac artery; CT angiography; CT, computed tomography; Mesenteric; Perforation; SMA, superior mesenteric artery; Small bowel; Surgical arterial graft.

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Figures

Fig 1
Fig. 1
Sixty-one-year old female with abdominal pain. Findings: Coronal curved reformatted image of CT mesenteric angiography (arterial phase) demonstrates retrograde graft from left common iliac artery to superior mesenteric artery. Note: Lack of contrast opacification and presence of patchy air pockets within the graft and pseudoaneurysm.
Fig 2
Fig. 2
Sixty-one-year old female with abdominal pain. Findings: Axial source image of CT mesenteric angiography (arterial phase) demonstrates portion of the synthetic arterial graft within the lumen of a small bowel loop. Note: Lack of contrast opacification and presence of patchy air pockets within the graft.
Fig 3
Fig. 3
Sixty-one-year old female with abdominal pain. Findings: Intraoperative photograph showing migration of surgical vascular graft into the bowel loop with bowel perforation.
See this image and copyright information in PMC

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