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Paraprosthetic Extravasation of Enteric Contrast: A Rare and Direct Sign of Secondary Aortoenteric Fistula

Ryan M. Peirce, Richard H. Jenkins and Peter MacEneaney

University of Chicago, Department of Radiology, 5841 S. Maryland Ave., Chicago, IL 60637.



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  		Fig. 1A. —72-year-old woman with aortobifemoral prosthesis placement 6 weeks earlier presented with fever, elevated WBC count, abdominal pain, and purulent groin drainage. CT (with enteric contrast only) reveals ring of high-contrast material surrounding left iliac limb of graft.

 


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  		Fig. 1B. —72-year-old woman with aortobifemoral prosthesis placement 6 weeks earlier presented with fever, elevated WBC count, abdominal pain, and purulent groin drainage. More caudal CT shows direct contact between sigmoid colon and left limb of graft. Communication between iliac limb of graft and sigmoid colon was confirmed at laparotomy.

 


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  		Fig. 1C. —72-year-old woman with aortobifemoral prosthesis placement 6 weeks earlier presented with fever, elevated WBC count, abdominal pain, and purulent groin drainage. More proximal CT reveals large air-fluid collection anterior to graft, representing an abscess. Air and enteric contrast material are present around bifurcation of aortic component of graft.

 

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