Successful surgical treatment of primary aorto-duodenal fistula associated with inflammatory abdominal aortic aneurysm: A case report

We report a rare case of a 50-year-old woman with intermittent gastrointestinal (GI) bleeding and diagnosed as having primary aortoenteric fistula (PAEF) with inflammatory abdominal aortic aneurysm (IAAA). She was transferred to our institution with suspected PAEF as assessed by duodenoscopy and CT...

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Bibliographic Details
Published inAnnals of thoracic and cardiovascular surgery Vol. 5; no. 3; p. 194
Main Authors Ikeda, K, Abe, T, Itou, M, Tamiya, Y, Tanaka, T, Kazui, T
Format Journal Article
LanguageEnglish
Published Japan 01.06.1999
Subjects
Aortic Aneurysm, Abdominal - complications
Aortic Aneurysm, Abdominal - surgery
Aortic Diseases - complications
Aortic Diseases - surgery
Aortitis - complications
Aortitis - surgery
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Duodenal Diseases - complications
Duodenal Diseases - surgery
Duodenoscopy
Female
Gastrointestinal Hemorrhage - etiology
Humans
Intestinal Fistula - complications
Intestinal Fistula - surgery
Laparotomy
Middle Aged
Omentum - transplantation
Polyethylene Terephthalates
Shock, Hemorrhagic - surgery
Surgical Flaps
Tomography, X-Ray Computed
Vascular Fistula - complications
Vascular Fistula - surgery
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Summary:We report a rare case of a 50-year-old woman with intermittent gastrointestinal (GI) bleeding and diagnosed as having primary aortoenteric fistula (PAEF) with inflammatory abdominal aortic aneurysm (IAAA). She was transferred to our institution with suspected PAEF as assessed by duodenoscopy and CT scan. As the patient was in shock due to massive GI-bleeding two days after admission, we performed an emergency laparotomy. The fistula was closed and the aneurysm replaced by a Woven Dacron Graft with an inter-positioning omental flap. A high index of suspicion is the most important diagnostic aid to prevent overlooking this often fatal disease.
ISSN:1341-1098