Here is a slice from the abdominal CT from the hematemesis patient. We were concerned about an aorto-enteric fistula and did IV contrast only. Note the two bright spots in the middle of the circularish lesion with an air/fluid level and air bubbles in it. What the heck is that???

CT scan with IV contrast only
Posted by Hello

The two bright spots are his aortic graft at the bifurcation. The white rim on the circular object is the calcified anuerismal sac. The old aneurismal sac is filled with air & stool from his bowel.

During surgery, aggressive epithelial tumors of the small bowel were identified, that had eroded through teh bowel and into the old aneurismal sac, causing a large peri-aortic-graft abcess. The bowel tumor was too extensive to resect and he was closed without repair following surgical drainage and placed in IV antibiotics.

What do you think of that???