Migration of Gentamicin Beads into Duodenum following Treatment of Primary Infection of the Aorta

IntroductionGentamicin impregnated beads have been used in the treatment and prevention of infections in vascular surgery.ReportA patient presented with sepsis 6 years after repair of an infrarenal aortic mycotic aneurysm with an in situ polytetrafluoroethylene (PTFE) graft and implanted gentamicin beads. Several beads migrated into the duodenum resulting in a paraprosthetic sinus. The patient was successfully treated with duodenal resection and Roux-en-Y anastomosis.DiscussionThis report highlights a serious complication relating to the implantation of gentamicin beads in the retroperitoneum. We would advocate aggressive debridement and coverage of the infected field with well-vascularised tissue rather than permanent gentamicin bead implantation.