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Special Feature
April 2008

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations: Department of Surgery, Medical College of Wisconsin, Milwaukee.

 

Author Affiliations: Department of Surgery, Medical College of Wisconsin, Milwaukee.

Arch Surg. 2008;143(4):423. doi:10.1001/archsurg.143.4.423

An 81-year-old man had a history of endovascular repair of an infrarenal abdominal aortic aneurysm, measuring 5.5 cm at the time of repair, with an Excluder stent graft (Gore, Flagstaff, Arizona). The patient had a medical history significant for a 60 pack-year smoking history, stroke, and pelvic irradiation for prostate cancer.

As part of the patient's routine surveillance, he underwent computed tomography (CT) of the abdomen and pelvis 2 years after stent graft placement (Figure>, A). This prompted an abdominal aortogram and selective mesenteric arteriogram (Figure, B).

Figure.
Computed tomography of the abdomen and pelvis (A) and superior mesenteric artery arteriogram (B).

Computed tomography of the abdomen and pelvis (A) and superior mesenteric artery arteriogram (B).

What Is the Diagnosis?

A. Pelvic abscess

B. Endoleak

C. Gastrointestinal hemorrhage

D. Stent graft migration

Answer

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