Aortoenteric Fistula

Abstract

Twenty-two patients developed one or more aortoenteric fistulae following aortic reconstruction with a dacron graft. Endoscopy was performed on 11 of these patients on 17 occasions and a preoperative diagnosis was made in eight patients. Fistulous communication was most common between the aorta and duodenum (60%), and a further 30% penetrated into the jejunum and ileum. The mean period from operation to time of diagnosis was 36 months and the mean length of bleeding was 25 days, allowing ample time for preoperative evaluation. Surgery was performed on 21 of the 22 patients with an overall mortality of 77%. The best surgical results were obtained with graft resection, closure of the aorta, and maintenance of circulation by an axillofemoral graft.

Fístula aortoentérica como causa de hemorragia digestiva en tres pacientes adultos

“…Tanto en las FAE primarias como en las secundarias la localización del trayecto fistuloso puede establecerse con cualquier porción del tubo digestivo, siendo más frecuente en el duodeno en alrededor del 80% de los casos (el 60% incluyen a la tercera porción, del 5% al 8% a la cuarta, el 3% a la segunda y el 1% a la primera). La localización menos común es la colónica, como la hallada en el segundo caso que presentamos 4 . El yeyuno y el íleon están comprometidos en cerca del 4% de los casos 5 .…”

Two Cases of Aorto-Gastrointestinal Fistula.

“…Survival wasnot related to the manneror degree of initial gastrointestinal hemorrhage, and the time interval from graft insertion to the development of an aorto-gastrointestinal fistula was quite variable and was not related to survival ( 16). Bleeding from an aorto-gastrointestinal fistula can occur anytime from the first postoperative week to 12 years after surgery and the meaninterval from operation to diagnosis is 36 months, emphasizing the importance of continuing vigilance (3). The chance of survival in patients who presented with hematemesisor melenawas significantly better whenthe time interval from onset of bleeding to operative intervention was short (16).…”

“…Themost serious complication is rupture of the aneurysm because it often leads to hypovolemic shock and death. An aorto-gastrointestinal fistula is a rare complication (1, 2), but it frequently causes massive and fatal gastrointestinal bleeding (3)(4)(5). Aorto-gastrointestinal fistulas are potentially curable, if diagnosed and treated with surgical intervention before the onset of lethal massive hemorrhage.…”

Clinical Presentations of Secondary Aortoenteric Fistulae: Case Report and Literature Review

“…Other etiologies include ulcers, tumor invasion, trauma, radiation therapy, and foreign body perforation. It was first reported in 1953 by Brock, while the first successful repair was reported in 1957 by Herberer (Champion, 1981) [11] .…”