scholarly journals Primary aortoduodenal fistula – overlooked because of guidelines?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Felix Wiesmueller ◽  
Clemens Neufert ◽  
Jürgen Siebler ◽  
Roland Croner ◽  
Werner Lang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Palliative Care ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Delayed Diagnosis ◽  
Emergency Laparotomy ◽  
Aortoduodenal Fistula ◽  
Computed Tomography Imaging ◽  
Tomography Imaging ◽  
Upper Gastrointestinal

AbstractPrimary aortoduodenal fistula is an uncommon yet mostly lethal finding. We present a case of a 63 year-old male who exhibited significant upper gastrointestinal bleeding and hemorrhagic shock. Repeated endoscopies did not detect any source of bleeding. Emergency laparotomy disclosed an aortoduodenal fistula. Despite intense medical efforts for several months the patient did not fully recover and treatment was limited to palliative care. In light of the substantial mortality associated with this condition, computed tomography imaging should be performed in case of doubt to prevent delayed diagnosis.

Life-Threatening Upper Gastrointestinal Bleeding Secondary to Aortoenteric Fistula

2008 ◽  
Vol 2 ◽  
pp. CCRPM.S376
Author(s):  
Tasbirul Islam ◽  
George Hines ◽  
Douglas S. Katz ◽  
William Purtil ◽  
Francis Castiller
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Gastrointestinal Bleeding ◽  
Surgical Repair ◽  
Upper Gastrointestinal Bleeding ◽  
Aortoduodenal Fistula ◽  
Open Surgical Repair ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Upper Gastrointestinal

We present a patient with gastrointestinal bleeding secondary to an aortoduodenal fistula. The patient had undergone an open surgical repair of an abdominal aortic aneurysm five years prior to admission.

Upper gastrointestinal bleeding and a unique computed tomography scan

Gut ◽  
2008 ◽  
Vol 57 (12) ◽  
pp. 1681-1681
Author(s):  
G S Abi Saad ◽  
K M Musallam ◽  
J Karam ◽  
A Al-Kutoubi ◽  
A N Tawil ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Computed Tomography Scan ◽  
Upper Gastrointestinal ◽  
Tomography Scan

scholarly journals Clinical and endoscopic features of aorto-duodenal fistula resulting in definitive diagnosis: an observational study

2020 ◽  
Author(s):  
Chikamasa Ichita ◽  
Akiko Sasaki ◽  
Chihiro Sumida ◽  
Karen Kimura ◽  
Takashi Nishino ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Vital Signs ◽  
Diagnostic Methods ◽  
Upper Endoscopy ◽  
Duodenal Fistula ◽  
Endoscopic Characteristics ◽  
Upper Gastrointestinal

Abstract Background: An aorto-duodenal fistula presents with upper gastrointestinal bleeding and hematemesis. Early diagnosis is difficult, and the disease is associated with high mortality. Sometimes, a small amount of bleeding, known as herald bleed, occurs repeatedly and may be judged as upper gastrointestinal bleeding, prompting emergency upper endoscopy. Diagnostic methods and surgical treatment during herald bleeding are important for saving lives. However, most fistulas form in the horizontal duodenum, and active bleeding is rarely found in patients with herald bleeding. Moreover, an aorto-duodenal fistula is rarely diagnosed based on upper endoscopy alone. Methods: The present study examined the clinical and endoscopic characteristics of aorto-duodenal fistula in eight patients who underwent upper endoscopy before diagnosis at our hospital. It also sought to clarify how aorto-duodenal fistula can be appropriately diagnosed. Results: All patients had a history of aortic treatment, and many could not be diagnosed by computed tomography scan or upper endoscopy alone. Regarding the endoscopic findings, patients were seen to have stent/vascular prosthesis exposure, which is diagnostic of aorto-duodenal fistula as well as pulsatile lesions and massive fresh bleeding of obscure origin in the duodenum. Conclusions: If the diagnosis is unclear, clinicians may need to observe the horizontal duodenum using a fitted tip attachment or long scope. Since vital signs may fluctuate during endoscopy, a series of tests should be performed immediately. Proactive placement of marking clips in likely areas of the fistula may facilitate diagnosis via computed tomography. The present results demonstrate that proper diagnosis and prompt surgical treatment save lives in patients with aorto-duodenal fistula.

Treatment of Upper Gastrointestinal Bleeding by Percutaneous Transsplenic Varices Embolization in Chronic Hepatic Schistosomiasis Japonicum Patients

2021 ◽  
Author(s):  
Ying Li ◽  
Ban Sheng Cai ◽  
Xin Li ◽  
Shuai Ju ◽  
Xiu Ying Yang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Abdominal Ct ◽  
X Ray ◽  
Before And After ◽  
Intraperitoneal Bleeding ◽  
Hepatic Portal Vein ◽  
Hepatic Portal ◽  
Upper Gastrointestinal

To evaluate percutaneous transsplenic varices embolization (PTSVE) in the treatment of upper gastrointestinal bleeding (UGIB) in patients with chronic hepatic schistosomiasis japonicum (CHS), 29 CHS patients (20 males and 9 females) complicated with UGIB were selected as the investigation subjects. The patients were treated by PTSVE under the guidance of X-ray fluoroscopy. The success rate of PTSVE and the rate of complications were observed. In addition, the degrees of varices before and after PTSVE were evaluated by abdominal computed tomography (CT). Results showed that 26 CHS patients (89.6%) were successfully treated with PTSVE. Three cases (10.3%) failed, and two experienced intraperitoneal bleeding within 1 week after PTSVE. The abdominal CT showed a significant decrease of the varices stage in coronary (P < 0.001), esophageal (P = 0.006), and paraesophageal (P = 0.013) varices, but slightly increased perisplenic varices within 1 month of the intervention (P = 0.014). PTSVE may be a safe and effective procedure for the treatment of UGIB in CHS patients, particularly suitable for those with a widened hepatic fissure and exposed hepatic portal vein trunk and an enlarged spleen.

scholarly journals Chronic gastrointestinal bleeding caused by a Dieulafoy’s lesion in the small intestine: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Javad Salimi ◽  
Mohamad Behzadi ◽  
Alireza Ramandi ◽  
Mehdi Jafarinia ◽  
Hamid Zand ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Bowel Loop ◽  
Case Presentation ◽  
Chronic Anemia ◽  
Dieulafoy’S Lesion ◽  
History Of ◽  
Upper Gastrointestinal ◽  
Chronic Gastrointestinal Bleeding

Abstract Introduction Dieulafoy’s lesion, first found by Paul Georges Dieulafoy, is an infrequent but important cause of recurrent upper gastrointestinal bleeding. The bleeding is usually severe, but patients rarely present with chronic, occult gastrointestinal bleeding. Case presentation In this article, we discuss the case of a 68-year-old caucasian man with a history of recurrent hematemesis and chronic anemia with evidence of extravasation of contrast in the lumen of the bowel loop on computed tomography angiography. The patient was taken to the operating room, and a laparotomy procedure was performed. Conclusion Due to the infrequency of Dieulafoy’s lesion compared with other causes of gastrointestinal bleeding, it is often missed in the process of differential diagnosis. In this article, we have demonstrated the importance of this disease and different approaches to the treatment of this lesion, considering the location of the lesion among other factors.

Role of computed tomography in upper gastrointestinal bleeding

2011 ◽  
Vol 72 (5) ◽  
pp. 293-293
Author(s):  
Rajaraman Durai ◽  
Daniel Thomas ◽  
Ahmad El Gaddal ◽  
Midhat Siddiqui
Keyword(s):  
Computed Tomography ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal
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