Diagnosis and management of primary aortoenteric fistulas-experience learned from eighteen patients

Aortoduodenal fistula following aortic reconstruction of a pseudoaneurysm caused by stab wound 12 years ago

“…Patients with AEF doomed to death before 1970's, and surgery is the only viable chance of a cure today (Saers and Scheltinga, 2005;Song et al, 2008). A review of 118 cases of AEF by Sweeney and Gadacs (1984) showed that the total and operation-related mortalities were 86% and 36%, respectively, and most of them died before diagnosis or surgical intervention.…”

“…The very low incidence of AEF in general population makes this condition a very uncommon entity in the differential diagnosis of GI bleeding. Therefore, physicians and gastroenterologists in the emergency departments usually have insufficient awareness of this rare disorder (Song et al, 2008). Here, we present a unique case of a post-stab pseudoaneurysm existing for 12 years together with a retained dagger in the abdomen, which was successfully managed with repair of primary aortic defects.…”

“…Rupture of the aorta through AEF into a closely adherent portion of the gastrointestinal (GI) tract may lead to GI bleeding, which may range from a minor and intermittent hemorrhage at its initial stages, to an life-threatening exsanguinations (Song et al, 2008;Saers and Scheltinga, 2005;Goshtasby et al, 2005). Despite advances in surgery and medical technology, these entities are still associated with significant morbidity and mortality for the patient; the mortality is as high as almost 100% if left untreated (Lemos et al, 2003).…”

The Evolution of Aortic Aneurysm Repair: Past Lessons and Future Directions

“…AEFs are difficult to diagnose with a high an index of suspicion needed in patients with previous aortic aneurysm surgery. If not treated promptly, AEFs are fatal (Voorhoeve et al 1996;Song Y et al 2008). Surgery offers the only definitive treatment.…”

Lower gastrointestinal bleeding as a result of fistula between the iliac artery and sigmoid colon in patient with advanced testicular cancer

“…Diagnosis of aorto-enteric fistulae, primary (very rare) and secondary, is complex. Morbidity and mortality are high when associated with bleeding and sepsis (2)(3)(4).…”