Aortoduodenal Fistula: Appearances on Computed Tomography

Daly, Ciara; Nott, David; Padley, Simon

doi:10.1111/j.1445-2197.1997.tb07127.x

Cited by 16 publications

(7 citation statements)

References 4 publications

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“…However, its purpose is to exclude other causes of major gastrointestinal hemorrhage. Conventional contrast enhanced CT scanning can demonstrate inflammatory changes around the vessel graft, such as peri-graft air locules or fluid changes, which is a diagnostic tool in around one-third of the cases [10]. Multiplanar contrast enhanced CT scan with three-dimensional reconstruction may prove an important non-invasive diagnostic tool in the future [11].…”

Section: Discussionmentioning

confidence: 99%

“…Multiplanar contrast enhanced CT scan with three-dimensional reconstruction may prove an important non-invasive diagnostic tool in the future [11]. On the other hand, the diagnostic sensitivity of percutaneous aortography is reported to be less than 20% [10]. However, angiograph with stenting to temporarily occlude an aortoenteric fistula [12] as well as endovascular balloon occlusion had been described [13].…”

Section: Discussionmentioning

confidence: 99%

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Aortoduodenal Fistula: A Rare Case of Recurrence

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Aortoduodenal Fistula: A Rare Case of Recurrence

et al. 2015

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“…However, finding lesions without active bleeding does not rule out an ADF and the length of the endoscope does not allow visualization of the distal duodenum where ADF occur [5]. Computed tomography with contrast is probably the most useful as it may show the communication or reveal loss of continuity and air bubbles in the aneurysm wall that are pathognomonic [6]. Percutaneous angiography is rarely of value since the need for it coincides with the need for immediate surgery [7].…”

Section: Discussionmentioning

confidence: 99%

Haematemesis due to primary aortic aneurysm-duodenal fistula - clinical suspicion is the cornerstone of diagnosis: a case report

Wijeyaratne

Ubayasiri

Weerasinghe

2009

Cases J

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IntroductionAlthough gastrointestinal haemorrhage from aortoduodenal fistulae secondary to previous aortic grafts are well known, a primary fistula from an aortic aneurysm is a rare consideration resulting in inappropriate management and poor outcomes.Case presentationWe report a previously fit 65-year-old Sri Lankan man who presented with severe anaemia (haemoglobin, 6 gm/dl), recent onset low backache. There was no history of analgesic abuse, peptic ulceration, alcohol excess, weight loss or malena. The abdomen was soft and there was no visceromegaly. A routine ultrasound detected an abdominal aortic aneurysm without signs of a leak. Two days later, while undergoing routine diagnostic tests for anaemia and backache, he had a massive haematemesis. Standard resuscitation was commenced with hope that common sources, either peptic ulcers or varicies would eventually stop bleeding enabling endoscopy and definitive treatment. However, persistent hypotension coupled with the clinical suspicion of an aortoduodenal fistula led to immediate surgical exploration rather than continued aggressive resuscitation. An aortoduodenal fistula was confirmed and both the duodenum and the aorta were successfully repaired by direct suture and synthetic graft replacement respectively. This man remains well nine months later.ConclusionGastrointestinal bleeding in the presence of an ‘asymptomatic’ abdominal aortic aneurysms should be assumed to be from a primary aortoduodenal fistula unless another source can be identified with certainty without delay.

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“…CT allows visualization of the retroperitoneum, the perigraft tissues, and helps define the relationship between the gastrointestinal tract and graft. Findings of persisting perigraft air or fluid, loss of tissue planes, adjacent bowel wall thickening or inflammation, and the presence of eroding graft or contrast material in the bowel are associated with AEF (6). Abnormalities are most often present on CT examinations, but absent frank findings of graft erosion or contrast extravasation into the bowel, are frequently considered non-diagnostic (7).…”

Section: Diagnosismentioning

confidence: 97%