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Murray K. Dalinka, MD; Antonio J. Reginato, MD; Henry D. Berkowitz, MD; Melvin L. Turner, DO; Bruce Freundlich, MD; Marvin Steinberg, MD

Arch Surg. 1982;117(10):1355-1359.

Abstract
• Diagnosis of an infected bifurcation graft or aortoenteric fistula can be extremely difficult, and delay in diagnosis may lead to the lethal complication of a ruptured aortoenteric fistula. Hypertrophic osteoarthropathy limited to the lower extremities was the initial symptom of aortoenteric fistula in two of our patients with infected aortic bifurcation grafts. Review of the literature discovered six additional patients with a similar diagnosis, indicating its possible value as an early diagnostic sign of aortoenteric fistula.

(Arch Surg 1982;117:1355-1359)

Author Affiliations
From the Departments of Radiology (Dr Dalinka), Surgery (Dr Berkowitz), Rheumatology (Dr Freundlich), and Orthopedics (Dr Steinberg), Hospital of the University of Pennsylvania, Philadelphia, the Department of Rheumatology, Cooper Medical Center, Camden, NJ (Dr Reginato), and the Department of Radiology, Saint Agnes Medical Center, Philadelphia (Dr Turner).

Footnotes
Accepted for publication May 20, 1982.

Reprint requests to Hospital of the University of Pennsylvania, Fourth Floor, Silverstein Pavilion, 3400 Spruce St, Philadelphia, PA 19104 (Dr Berkowitz).

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