Graft-duodenal fistula – a cause of massive gastrointestinal bleeding

Česká verzia

Authors: J. Maceček ¹ ; B. Staňka ¹; J. Šťastný ^1,2
Authors place of work: Gastroenterologické oddělení, Nemocnice Prostějov, Středomoravská nemocniční a. s. ¹; Chirurgické oddělení, Nemocnice Prostějov, Středomoravská nemocniční a. s. ²
Published in the journal: Gastroent Hepatol 2017; 71(4): 310-314
Category: Clinical and Experimental Gastroenterology: Case Report
doi: https://doi.org/10.14735/amgh2017310

Summary

Pathological communication between the aorta and the digestive tract is a very serious condition, has a high mortality rate, and ranks between a sudden abdominal and a sudden vascular event. The first manifestation is most commonly upper gastrointestinal tract bleeding. Aorto-enteric fistula is a pathological connection between the aorta and the small intestine, most often the duodenum. This is a rare pathological condition that, without acute causal therapy, always ends in the death of the patient. Its early diagnosis, a condition for successful therapy, is problematic. More often, in clinical practice, it is a secondary so-called graft-enteric (duodenal) fistula. Primary aortoenteric (duodenal) fistula is rare and is always associated with aortic pathologies, such as aneurysm or inflammatory changes of the aorta. Equally rare is a connection between a stent graft after previous endovascular treatment of the abdominal aortic aneurysm and the digestive tract. We present a case report of a patient who was successfully diagnosed with a fistula, whose first manifestation was intermittent enterorrhagia, but later progressed to massive bleeding, resulting in an acute operation. Due to the severity of the condition and patient’s age, he died in the early postoperative period. This case points to the importance of a precise disease history, timely diagnosis, and proper diagnostics for successful therapy, which is generally very demanding.

Key words:
enterorrhagia – aortoenteric fistula – graft-enteric fistula

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
4. 5. 2017

Accepted:
8. 7. 2017

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