Computed tomography fistulography of the sternum. A case report on interprofessional collaboration between radiologist and surgeon

INTRODUCTION: Trans sternal fistula can occur after sternotomy/heart surgery. Diagnosing this can be difficult. PRESENTATION OF CASE: In this report, we present a unique case of a patient with infection of an ascending aortic prosthetic graft. This patient was oozing from the wound despite several revisions. Many fistulographies were performed before fistulography with surgeon and radiologist revealed a trans sternal fistula. DISCUSSION: Infection with Propionibacterium acnes is often difficult to diagnose. This is in line with the present case, where a surgeon guided fistulography had to be performed followed by appropriate redo surgery with succesful subsequent sternal wound healing. CONCLUSION: Our case demonstrates the importance of performing a fistulography with the presence of a surgeon, to obtain the best possible result.