Primary aortoenteric fistula Report of two cases

Authors:

Publish Date: 1994/03

Volume: 3, Issue: 01, Pages: 32-35

PDF Link

Abstract

The authors report 2 cases of primary aortoenteric fistula and discuss a number of interesting features demonstrated by them The first patient a fiftysixyearold woman underwent a right hemicolectomy for carcinoma in 1986 and presented three years later with massive hematemesis and hematochezia At emergency laparotomy a fistulous communication was found between the fourth portion of the duodenum and the aorta caused by carcinomatous retroperitoneal nodes A Dacron tube graft was placed in the aorta and the duodenum was repaired with limited resection and endtoend anastomosis The patient recovered well but she died on the thirtieth postoperative day in profound hypovolemic shock The second case a sixtysevenyearold man presented with an abdominal pulsatile mass and a fortyeighthour history of abdominal pain weakness and melena Ultrasonic and computed tomographic examination indicated a small infrarenal aortic aneurysm communicating with the bowel At laparotomy a fistulus tract was found between the aneurysm and the jejunum The aneurysm was replaced by a Dacron tube graft and the jejunum was repaired with resection and endtoend anastomosis Recovery was uneventful and the patient remains well fifteen months later

Keywords: