Aorto-duodenal and subsequent aorto-colonic fistula following operation for ruptured aortic aneurysm

Abstract

Direct communication between aorta and intestinal lumen, whether spontaneous (primary) or postoperative (secondary), is a rate and frequently lethal cause of gastrointestinal haemorrhage. This paper records what is believed to be a unique occurrence in the survival of a patient who following surgery for ruptured aortic aneurysm, not only developed an aorto-duodenal but subsequently an aorto-colonic fistula over a span of 5 years.

Aortic Paraprosthetic-colonic Fistulae: A Review of the Literature

“…The technique for GI tract reconstruction differs in cases of colonic compared to duodenal or jejunal involvement. For the latter, either a lateral bowel repair 10 or resection and end-to-end anastomosis of grossly normal bowel usually suffices, given the lower virulence of the bacteria populating the upper GI tract compared with the lower. The bowel can be hand sewn, or anastomosed end-to-end with an EEA stapler or side-to-side with a GIA stapler.…”

“…Aortic Paraprosthetic-colonic Fistulae SAEF. 10,64 Permanent synthetic sutures have reduced the incidence of suture line failure.…”

Atypical endoscopic finding in a case of secondary aorto‐colonic fistula

“…Abdominal CT was helpful in one case of aorto‐colonic fistula 2 but the subtle change on computed tomography was only seen postoperatively. Angiographies have been non‐diagnostic in past cases presumably because of the intermittent nature of the bleed and mural clots 3 .…”