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The presence of bilirubin in the perigraft fluid collections as an indicator of graft-enteric fistula
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Abstract
Material and methods. Twenty-four fluid samples from perigraft fluid collections were analyzed. The samples were obtained from 17 patients with suspected vascular prosthetic graft infection, including 5 patients with intraoperatively diagnosed graft-enteric fistulas and from 7 patients who underwent Dacron mesh repair of abdominal hernias.
Results. High concentrations of total and direct bilirubin, low concentrations of urea and an absence of inflammatory infiltration surrounding the fluid collection in the patients with graft-enteric fistulas were found. The total to direct bilirubin ratio was low, which indicated the dominance of direct bilirubin. In patients without graft-enteric fistulas and in patients after abdominal hernia mesh repair the concentration of total and direct bilirubin was lower, the concentration of urea was higher and inflammatory infiltration around fluid collection was observed. The differences, however, did not reach statistical significance.
Conclusions. High concentrations of total and direct bilirubin in perigraft fluid are not an unequivocal sign of the coexistence of graft-enteric fistulas. The low concentration of urea could be more useful in differential diagnosis of perigraft fluid collections.
Abstract
Material and methods. Twenty-four fluid samples from perigraft fluid collections were analyzed. The samples were obtained from 17 patients with suspected vascular prosthetic graft infection, including 5 patients with intraoperatively diagnosed graft-enteric fistulas and from 7 patients who underwent Dacron mesh repair of abdominal hernias.
Results. High concentrations of total and direct bilirubin, low concentrations of urea and an absence of inflammatory infiltration surrounding the fluid collection in the patients with graft-enteric fistulas were found. The total to direct bilirubin ratio was low, which indicated the dominance of direct bilirubin. In patients without graft-enteric fistulas and in patients after abdominal hernia mesh repair the concentration of total and direct bilirubin was lower, the concentration of urea was higher and inflammatory infiltration around fluid collection was observed. The differences, however, did not reach statistical significance.
Conclusions. High concentrations of total and direct bilirubin in perigraft fluid are not an unequivocal sign of the coexistence of graft-enteric fistulas. The low concentration of urea could be more useful in differential diagnosis of perigraft fluid collections.
Keywords
vascular graft; prosthetic graft infection; diagnosis; bilirubin
About this articleTitle
The presence of bilirubin in the perigraft fluid collections as an indicator of graft-enteric fistula
Journal
Issue
Article type
Research paper
Pages
156-165
Published online
2007-09-26
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592
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1280
Bibliographic record
Acta Angiologica 2007;13(4):156-165.
Keywords
vascular graft
prosthetic graft infection
diagnosis
bilirubin
Authors
Marcin Gabriel
Łukasz Dzieciuchowicz
Andrzej A. Jawień
Grzegorz Oszkinis
Katarzyna Pawlaczyk
Fryderyk Pukacki
Zbigniew Krasiński