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Aortointestinal Fistula – A Serious Complication of Surgery on Aortic and Pelvic Arteries


Authors: Z. Šilhart;  J. Ničovský;  I. Hanke;  I. Zavřelová 1
Authors place of work: Chirurgická klinika LF MU a FN Brno-Bohunice, přednosta: prof. MUDr. J. Vomela, CSc. ;  Ústav patologie FN Brno-Bohunice, přednosta: prof. MUDr. J. Mačák, CSc. 1
Published in the journal: Rozhl. Chir., 2007, roč. 86, č. 5, s. 224-227.
Category: Monothematic special - Original

Summary

Aortoenteral fistula (AEF) is a rare, but a serious complication in the vascular surgery. It may occur as a primary or a secondary fistula. The principal sign of the condition is bleeding from the gastrointestinal tract (GIT), which, depending on its severity, may present with various symptoms (anemia, melena, hematemesis). The authors describe three cases of patients who experienced AEF. In all the cases, signs of massive GIT bleeding were present with a rapid development of hemorrhagic shock. In a single case, the primary fistula was concerned, in two cases the fistula was secondary. The perioperative mortality rate reached 66%. The surgical management approach is discussed in the article, and early diagnosis and prevention of the complication is emphasized.

Key words:
aortoenteral fistula – abdominal aortic aneurysm – aortobifemoral bypass – axilobifemoral bypass – primary and secondary fistula


Zdroje

1. Sierra, J., Kalangos, A., Faidutti, B., Christenson, J. T. Aorto-enteric fistula is a serious complication to aortic surgery. Modern trends in diagnosis and therapy. Cardiovascular Surgery, Vol. 11, No. 3, 2003, pp. 185–188.

2. Harris, J. P., Sheil, A. G. R., Stephen, M. S., Storey, D. W., May, J. Lessons learnt in the management of aortoenteric fistulae. J. Cardiovasc. Surg., 28, 1987, pp. 449–452 .

3. Vobořil, Z. Krvácení z aortointestinální píštěle. Rozhl. Chir., 2006, 85, č. 6, s. 296–298.

4. Tomlinson, M. A., Gold, B., Thomson, M. H., Browning, N. G. Endovascular Stent Graft Repair of a Recurrent Aorto-enteric Fistula. Eur. J. BASF Endovasc. Surg., 2002, 24, s. 459–461.

5. Daněk, T., Maixner, R., Havlíček, K. Poperační komplikace perforovaného aneuryzmatu abdominální aorty – kazuistika. Rozhl. Chir., 2006, 85, č. 1, s. 28–30.

6. Vollmar, J. F., Kogel, H. Aorto-enteric fistulas as postoperative complication. J. Cardiovasc. Surg., 28, 1987, pp. 479–484.

7. Criadi, F. J., Classen, J. N., Wilson, T. H. Secondary aorto-enteric fistulas: Prosthetic and paraprostethic. The American surgeon, July 1981, vol. 47, pp. 313–321.

Štítky
Surgery Orthopaedics Trauma surgery

Článok vyšiel v časopise

Perspectives in Surgery

Číslo 5

2007 Číslo 5
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