Stent graft infection secondary to appendicitis: an unusual complication of endovascular abdominal aortic aneurysm repair

We present a case of a 73-year-old gentleman with an aortic endograft infection post endovascular abdominal aneurysm repair (EVAR), from whence erosion has come in from an acutely inflamed appendix. To our best understanding, there is no similar case published in the literature. Intra-operatively, there was obvious inflammation and oedema over the retroperitoneal tissue, with frank pus and thrombotic material projecting from the aorta. The tip of an obviously inflamed appendix had stuck to and eroded through the aortic sac, seeding the infection. The endograft was explanted and the aneurysm sac oversewn. Lower limb circulation was preserved with a right axillo-femoral Dacron bypass graft. This case highlights a rare complication following EVAR, and for one to consider unusual sources of graft infection.