Successful surgery for secondary aortoduodenal fistula based on 18F-fluorodeoxyglucose positron emission tomography/computed tomography findings

Satoshi Sakakibara; Takayuki Shijo; Koichi Maeda; Kizuku Yamashita; Toru Ide; Ryota Matsumoto; Kazuo Shimamura; Shigeru Miyagawa

doi:10.1016/j.jvscit.2023.101162

Successful surgery for secondary aortoduodenal fistula based on ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography findings

J Vasc Surg Cases Innov Tech. 2023 Mar 21;9(2):101162. doi: 10.1016/j.jvscit.2023.101162. eCollection 2023 Jun.

Authors

Satoshi Sakakibara¹, Takayuki Shijo¹, Koichi Maeda¹, Kizuku Yamashita¹, Toru Ide¹, Ryota Matsumoto¹, Kazuo Shimamura¹, Shigeru Miyagawa¹

Affiliation

¹ Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

Abstract

Secondary aortoduodenal fistula (sADF) is a critical late complication of abdominal aortic repair, requiring complete excision of the infected prosthesis. However, this is a highly invasive procedure for the elderly. We describe a case of sADF repair in a 76-year-old woman. Through ¹⁸F (fluorine-18)-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography mapping, focal high FDG uptake at the sADF site, right medial limb, and ligated left lateral limb of the prosthesis was detected. The duodenal and prosthetic grafts were partially resected. The proximal and distal anastomotic segments, with no FDG uptake, were retained. The abdominal aorta was reconstructed using a bovine pericardium roll and femorofemoral bypass. Thus, FDG positron emission tomography/computed tomography mapping of the infection site could help in such cases.

Keywords: 18F-fluorodeoxyglucose PET; Aortoduodenal fistula; Infection mapping.

Publication types

Case Reports