Fig. 14

A 65-year-old man presents 6 months post-thoracic endovascular aneurysm repair (TEVAR) with fever and haemoptysis. (a) An axial non-contrast CT thorax image demonstrates new air within the excluded aneurysm sac (arrow), immediately posterior to the oesophagus (*). There is adjacent left lower lobe consolidation with associated pleural effusion. (b) An axial CT of the thorax acquired 70 s post-contrast demonstrates a peripherally enhancing periaortic fluid collection (curved arrow) at the inferior aspect of the stent graft consistent with an abscess. (c) A barium swallow confirms the presence of an aorto-oesophageal fistula (arrows). The overall diagnosis is consistent with a thoracic stent graft infection with an aorto-oesophageal fistula, likely caused by the adjacent left lower lobe pneumonia. The patient died despite surgical intervention, with no definite organism identified. Ao = descending thoracic aorta; Eo = oesophagus