Direct visualization of postoperative aortobronchial fistula on computed tomography

Figure 8 Diagnostic steps to treatment of peri-graft air after thoracic aorta procedure. When peri-graft air is observed, first check for surrounding bronchiectasis, and if there is no dilated bronchiole, it may not be true aortobronchial fistula (ABF). If there is a dilated bronchiole, ABF is suspected. If the dirty fat sign or ring enhancement around peri-graft air are observed, graft infection is strongly suspected and treatment is required. Next, check for endoleaks and pseudoaneurysms, and if any are found, there is a risk of hemoptysis, so aggressive treatment should be considered. If the patient does not have any of the described findings, is asymptomatic, and persistence of the ABF can be confirmed, follow-up observation is possible. ABF: Aortobronchial fistula.