Fístula aortoduodenal primaria: una causa rara y potencialmente fatal de hemorragia digestiva

Barba, Elena Romera; Pérez, Ainhoa Sánchez; Puche, Julia Bertelli; Pérez, Casanova; Rojas, José Luis Vázquez

doi:10.1016/j.ciresp.2014.05.011

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…AEFs can be classified into primary and secondary types according to the presence or absence of a prior history of aortic surgery. Secondary AEFs, which occur in patients who have had previous aortic prosthetic reconstruction and are produced by an erosion of the aortic prosthesis into the GI tract, are 10 times more frequent than primary AEFs [ 7 ]. Primary AEFs are associated with spontaneous rupture of the expanding aorta into a closely adherent portion of the GI tract, which may lead to GI bleeding with presentation of a minor or intermittent hemorrhage (herald bleeding) in the initial stage or life-threatening exsanguination in the late stage [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report

Lin

Tsai

Chang

et al. 2018

BMC Cardiovasc Disord

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BackgroundPrimary aortoduodenal fistula (ADF) is a rare cause of gastrointestinal (GI) bleeding and is difficult to diagnose as the clinical presentation is subtle. Clinicians should keep a high level of suspicion for an unknown etiology of GI bleeding, especially in older patients with or without abdominal aortic aneurysm (AAA). Computed tomographic angiography (CTA) can be used to detect primary ADF. Open surgery or endovascular aortic repair (EVAR) for ADF with bleeding will improve the survival rate.Case presentationWe report a rare case of AAA complicating ADF with massive GI bleeding in a 73-year-old Taiwanese man. He presented with abdominal pain and tarry stool for 5 days and an initial upper GI endoscopy at a rural hospital showed gastric ulcer only, but hypotension with tachycardia and a drop in hemoglobin of 9 g/dl from 12 g/dl occurred the next day. He was referred to our hospital for EVAR and primary closure of fistula defect due to massive GI bleeding with shock from ADF caused by AAA. Diagnosis was made by CTA of aorta.ConclusionsA timely and accurate diagnosis of primary ADF may be challenging due to insidious episodes of GI bleeding, which are frequently under-diagnosed until the occurrence of massive hemorrhage. Clinical physicians should keep a high index of awareness for primary ADF, especially in elderly patients with unknown etiology of upper GI bleeding with or without a known AAA.

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Section: Discussionmentioning

confidence: 99%

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report

Lin

Tsai

Chang

et al. 2018

BMC Cardiovasc Disord

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“…The aorto-duodenal fistula (ADF) is a rare and potentially fatal complication with the incidence ranging between 0.04% and 0.07%, in autopsies 25 - 27. It is defined as an abnormal communication between the aorta and the duodenum, and is classified in primary when associated with aneurysms, and secondary when related to surgical procedures—the occurrence of which is 10 times more frequent 28.…”

Section: Discussionmentioning

confidence: 99%

Mycotic aneurysm with aortoduodenal fistula

et al. 2017

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Firstly described in the 19th century by Sir William Osler, the mycotic aneurysm (MA) is a rare entity characterized by an abnormal arterial dilation, which is potentially fatal, and is associated with the infection of the vascular wall. Elderly patients are mostly involved, especially when risk factors like chronic diseases, immunosuppression, neoplasia, and arterial manipulation are associated. The authors report the case of a young male patient diagnosed with an aortic aneurysm of infectious origin in the presence of repeated negative blood cultures. The diagnostic hypothesis was raised when the patient was hospitalized for an inguinal hernia surgery. The diagnosis was confirmed based on imaging findings consistent with mycotic aneurism. The patient was treated with an endovascular prosthesis associated with a long-lasting antibiotic therapy. Five months later, the patient attended the emergency unit presenting an upper digestive hemorrhage and shock, from which he died. The autopsy revealed a huge aneurysm of the abdominal aorta with an aortoduodenal fistula. The histological examination of the arterial wall revealed a marked inflammatory process, extensive destruction of the arterial wall, and the presence of Gram-positive bacteria. This case highlights the atypical presentation of a MA associated with an aortoduodenal fistula. Besides the early age of the patient, no primary arterial disease could be found, and no source of infection was detected.

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Extraabdominal Rupture of an Inflammatory Abdominal Aortic Aneurysm in a Patient With Aortodecubital Fistula: A Case Report

Panyko

Dubovský

Vician

2021

Annals of Vascular Surgery

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Fístula aortoduodenal primaria: una causa rara y potencialmente fatal de hemorragia digestiva

Cited by 6 publications

References 11 publications

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report

Primary aortoduodenal fistula associated with abdominal aortic aneurysm with presentation of gastrointestinal bleeding: a case report

Mycotic aneurysm with aortoduodenal fistula

Extraabdominal Rupture of an Inflammatory Abdominal Aortic Aneurysm in a Patient With Aortodecubital Fistula: A Case Report

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