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

• Published in: Annals 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
• Language: English
• 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
• ISSN: 1341-1098

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.