Unusual presentations of aorto-enteric fistula

Ramanujam, Srihari; Shiels, Aaron J.; Zuckerman, Gary R.; Prakash, Chandra

doi:10.1016/s0016-5107(03)02357-5

Cited by 30 publications

(21 citation statements)

References 13 publications

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“…For example, aortoenteric fistula must be considered in patients with a history of intra-abdominal vascular surgery, such as an abdominal aortic aneurysm repair [24]. Hemobilia is another rare cause of UGIB that should be considered in the setting of recent hepatobiliary tree instrumentation, such as with endoscopic retrograde cholangiopancreatography or laparoscopic cholecystectomy.…”

Section: Causes Of Acute Nonvariceal Ugibmentioning

confidence: 99%

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes

Loffroy

Favelier

Pottecher

et al. 2015

Diagnostic and Interventional Imaging

106

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Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting.

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Section: Causes Of Acute Nonvariceal Ugibmentioning

confidence: 99%

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes

Loffroy

Favelier

Pottecher

et al. 2015

Diagnostic and Interventional Imaging

106

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“…Die anatomischen Gegebenheiten bedingen dabei in 60-90% eine Lokalisation der aortointestinalen Fistel im Duodenum [4,7]. Hierbei überwiegt mit 57% wiederum die Pars horizontalis duodeni [7,11]. Aortointestinale Fistelverbindungen in Ösophagus, Magen, Jejunum, Ileum und Kolon sind lediglich kasuistisch beschrieben [1,5,11,15].…”

Section: Primäre Und Sekundäre Aortointestinale Fistelbildungenunclassified

“…Hierbei überwiegt mit 57% wiederum die Pars horizontalis duodeni [7,11]. Aortointestinale Fistelverbindungen in Ösophagus, Magen, Jejunum, Ileum und Kolon sind lediglich kasuistisch beschrieben [1,5,11,15]. Der intermittierende Charakter der Blutung erschwert die Lokalisation der Blutungsquelle und bedingt eine Latenz von der ersten Blutung ("herald bleeding"') zur Diagnosestellung der aortointestalen Fistel von ca.…”

Section: Primäre Und Sekundäre Aortointestinale Fistelbildungenunclassified

Rezidivierende obere gastrointestinale Blutungen bei einem 61-jährigen Patienten mit infrarenalem Bauchaortenaneurysma

et al. 2008

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A 61-year-old man was admitted to hospital due to recurrent upper gastrointestinal bleeding. Four weeks ago, he had been treated with epinephrine and endoclips by endoscopy due to an arterial gastrointestinal bleeding. The patient had a history of coronary and peripheral artery disease, diabetes, and an abdominal aortic aneurysm. Urgent endoscopy suggested the presence of an ulcus Dieulafoy but no definitive bleeding source could be seen. Due to ongoing melena an abdominal computer tomography was performed and a primary aortoduodenal fistula was suspected caused by the infrarenal abdominal aortic aneurysm. Laparatomy was undertaken emergently and an aortoduodenal fistula was found in the descending part of the duodenum. Repair of the duodenal rent was performed and the aortic aneurysm was replaced by a Dacron prosthesis. The patient was transferred to the intensive care unit. 4 days after initial admission, he died due to septic shock.

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“…Den sekundären Fisteln gegenüber stehen die sehr viel selteneren primären Fistelbildungen (Fall 2), denen überwiegend ein arteriosklerotisches Bauchaortenaneurysma mit Ruptur in den Gastrointestinaltrakt zugrunde liegt [3,9]. Seltenere Ursachen primärer aortointestinaler Fisteln sind Strahlenfolgen [10], Malignome [5] und Perforationen aus arteriosklerotischen Ulzera [11]. Aortointestinale Fisteln werden in ca.…”

Section: Kasuistikunclassified

Aortoduodenale Fistel als Ursache der gastrointestinalen Blutung - eine endoskopisch schwierige Differenzialdiagnose

Probst¹,

Bittinger²,

Eberl³

et al. 2006

Z Gastroenterol

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We report on three patients with severe gastrointestinal bleeding arising from aortoenteric fistula. Two patients presented with a secondary aortoduodenal fistula. In the first case bleeding occurred 8 months after aortobifemoral graft implantation. In the second patient aortobiliacal graft implantation was performed 22 years before. In the third case the aortoenteric fistula was primary and was caused by an abdominal aortic aneurysm without prior vascular intervention. In the first case diagnosis was made by urgent endoscopy visualizing ongoing bleeding from the duodenal fistula. In the two other patients urgent endoscopy and CT as well could not demonstrate the bleeding source. Aortoenteric fistula was diagnosed endoscopically during severe rebleeding some hours later. Two patients underwent surgery with implantation of an axillobifemoral bypass; the third patient declined further intervention and died. The course shows that aortoduodenal fistula can present with severe but intermittent gastrointestinal bleeding making the diagnosis in the non-bleeding interval difficult. In patients with severe gastrointestinal bleeding and a history of aortic disease (aneurysm, prior aortic graft repair or stenting) an aortoduodenal fistula should be suspected and the indication for surgical intervention should be considered early in spite of negative results of endoscopy and CT.

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Unusual presentations of aorto-enteric fistula

Cited by 30 publications

References 13 publications

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes

Rezidivierende obere gastrointestinale Blutungen bei einem 61-jährigen Patienten mit infrarenalem Bauchaortenaneurysma

Aortoduodenale Fistel als Ursache der gastrointestinalen Blutung - eine endoskopisch schwierige Differenzialdiagnose

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