Aortoenteric Fistulae: Present-Day Management

Abstract

An aortoenteric fistula (AEF) is a communication between the aorta and an adjacent loop of the bowel. The three most useful diagnostic modalities for detecting AEF are abdominal computed tomography scan with intravenous contrast, esophagogastroduodenoscopy, and arteriography. The treatment of AEFs has improved in recent years, but despite the multiple surgical techniques reported, many of the patients do not survive or are left debilitated after treatment. Endovascular repair is an efficient and safe method to stabilize patients with life-threatening AEFs. The aim of this study is to provide a comprehensive and synthetic review of the latest advantages on the diagnosis and management of primary and secondary AEF.

Imaging work-up and endovascular treatment options for aorto-enteric fistula

“…With in situ reconstruction, the aortic reconstruction is performed immediately after the affected graft is excised. Candidate conduits for aortic reconstruction include a new synthetic graft, arterial homograft, or autogenous femoral venous graft (28). In addition, concomitant surgical repair of the intestinal defect is achieved at the same time.…”

“…However, even in situ vein grafting for SAEF is associated with an in-hospital mortality rate of 32%, which is considerably higher than the 7% in-hospital mortality of endovascular treatment of SAEF (3,29). Despite decades of attempted improvement and development of novel techniques, morbidity and mortality associated with open surgical repair of SAEF remain major obstacles (28,(30)(31)(32). Figure 2 presents a 64-yearold man with a prior thoracic aortic aneurysm endograft repair.…”

Re: Inflammatory myofibroblastic tumour of sigmoid mesocolon in a child

“…4 Endoscopy findings of an ulcer or erosion adjacent to a blood clot with an extrinsic pulsatile mass in the duodenum are highly indicative of primary aorto-enteric fistulae. 5…”

Gastrointestinal bleeding caused by false symptomatic infrarenal abdominal aortic aneurysm

“…Кроме этого, аневризма брюшного отдела аорты может пенетрировать в желудок, тощую, подвздошную или сигмовидную кишку. Другие симптомы встречаются реже, это боль в животе, пальпируемое пульсирующее образование передней брюшной стенки, боль в спине, мелена, лихорадка или обморок [2][3][4][5][6].…”