Aorto-Enteric Fistulae: An Uncommon Complication of Abdominal Aortic Aneurysms

Abstract

SUMMARYThree cases of aorto-enteric fistula which have been treated successfully by resection of the aortic aneurysm are described. Only 5 other successful cases have been reported. One hundred and thirtyone cases are reviewed and analysed, and though more than half of these survived for 24 hours or longer after the first gastro-intestinal haemorrhage, no untreated long-term survival has been recorded.We feel that urgent assessment and early corrective surgery is the only treatment which offers a reasonable chance of survival.

Primary Aortoduodenal Fistula: Successful Surgical Treatment

“…10 The pain that occurs in the primary variety is similar to that encountered in abdominal aortic aneurysms in general and is located in the abdomen, back, or flank. Occasionally a patient presents with the full triad of gastrointestinal bleeding, an abdominal mass, and pain.…”

“…1,9,10 The usual chain of events is one in which the third and fourth portions of the duodenum are draped over an atherosclerotic, or less commonly a mycotic, abdominal aortic aneurysm. As the aneurysm enlarges, it results in pressure on stretching of the duodenal wall leading to both a thinning and a compromising of the blood supply to the posterior wall of the duodenum.…”

Imaging work-up and endovascular treatment options for aorto-enteric fistula

“…However, even in situ vein grafting for SAEF is associated with an in-hospital mortality rate of 32%, which is considerably higher than the 7% in-hospital mortality of endovascular treatment of SAEF (3,29). Despite decades of attempted improvement and development of novel techniques, morbidity and mortality associated with open surgical repair of SAEF remain major obstacles (28,(30)(31)(32). Figure 2 presents a 64-yearold man with a prior thoracic aortic aneurysm endograft repair.…”

Chronic Ilio-Caval Fistula Presenting 23 years later as Congestive Heart Failure and Atrial Fibrillation

“…High-output heart failure due to post-traumatic aortocaval fistula is rare, unlike atherosclerotic abdominal aortic aneurysms [4,5]. In this paper, we represent a case of congestive heart failure that resulted from an ilio-caval fistula following a traumatic injury in a man with no prior cardiac disease.…”