Rupture of Aortic Aneurysms Into the Gut

Abstract

Rupture of an aortic aneurysm into the gut is uncommon. The duodenum is most often involved, stomach and jejunum being next in order of frequency. Involvement of the cesophagus is now decidedly rare probably due to the declining incidence of cardiovascular syphilis.We report three cases of aortic aneurysm; two in the abdomen ruptured into the second part of the duodenum and one in the thorax into the cesophagus. A fistula between aorta and inferior vena cava was also present in one of the cases with an abdominal aneurysm; in the other the wall of the inferior vena cava was partially eroded.CASE REPORTS Case 1. This woman, aged 84, was found dead at home: she had, apparently, been in good health for the past thirty years.Necropsy (P54.086). A small saccular aneurysm (3 0 cm. diameter) arose from the very atheromatous aorta 7 cm. distal to the coeliac axis. It contained thrombus and communicated with the second part of the duodenum through a hole, 0 5 cm. diameter, at the duodenum end (Fig.

Gastro-Intestinal Bleeding Due to Arterio-Enteric Fistula

“…In the remaining cases the fistulas were into the oesophagus, stomach, jejunum and in the rarest cases to the ileum or sygmoid colon [1,4,8,9,18,23]. There are no fistulas between the main arterial tree and the coecum mentioned in the literature, as in our 4th case.…”

Primary aortoduodenal fistula: a rare entity with lethal effects

“…Most AEF involve the duodenum (60%), but fistulae between the aorta and the GI tract can occur from the oesophagus to the colon 5. The declining incidence of oesophageal aortic fistulae is primarily due to the declining prevalence of syphilis, but the remainder of the distribution appears to have stayed the same since its first discovery in the midnineteenth century 10. The aetiology of primary ADF is more controversial and likely more idiosyncratic.…”

Giant syphilitic aortic aneurysm: A case report and review of the literature

“…12 Large syphilitic thoracic aortic aneurysms may cause symptoms via mass effect on neighboring mediastinal structures, including the trachea, esophagus and pulmonary artery, [13][14][15] as in our patient. Additional reported complications include compression of the superior vena cava, 16 erosion into the chest wall 17 and thoracic spinal bodies, 18 erosion into the airways 19 and esophagus, 20 and fistulization to the pulmonary artery. 21 As with aneurysms of other etiologies, patients with syphilitic aortitis are at risk for dissection and rupture.…”