scholarly journals Aortoduodenal fistula after abdominal aortic aneurism resection: Two case reports

2020 ◽  
Vol 77 (9) ◽  
pp. 992-999
Author(s):  
Aleksandar Tomic ◽  
Ivan Marjanovic ◽  
Zoran Kostic ◽  
Miroslav Mitrovic ◽  
Damjan Slavkovic ◽  
...  
Keyword(s):  
Stent Graft ◽  
Case Reports ◽  
Aortic Surgery ◽  
Multiple Organ ◽  
Aortoduodenal Fistula ◽  
Complete Excision ◽  
Free Air ◽  
Abdominal Aortic ◽  
Abdominal Aortic Aneurism ◽  
Urgent Operation

Introduction. Aortoenteric fistula (AEF) is rare and extremely difficult complication of aortic surgery. We presented two cases of secondary aortoduodenal fistula (SADF) as complication after aortic surgery. Case reports. In the first patient SADF happened 11 years after open abdominal aneurysmal resection with gastrointestinal tract (GIT) bleeding. After negative esophagogastroduodenoscopy (EGDS) we performed multislice computed tomography (MSCT) which revealed contrast leakage in duodenum from 10 cm wide visceral aortic aneurysm. The patient was treated with graft excision, aneurysmal reduction, sewing of proximal and distal aortal stumps, bowel repair followed by axillobifemoral bypass (AxFF). The patient dismissed on 30th postoperative day. The second case of ADF happened five months after endovascular reconstruction of abdominal aorta with GIT bleeding and fewer. During following 8 days, he had three negative EGDS. On MSCT we found signs of endoleak, free air in aneurysmal sac, and signs of blood in the intestine. On urgent operation we extracted stent graft, sewed proximal and distal aortal stumps, performed bowel repair and AxFF. The patient died a day after operation with signs of sepsis and multiple organ failure syndrome. Conclusion. Conventional treatment of ADF means extraanatomic AxFF with complete excision of infected graft or stent graft, with closure of aorta?s proximal and distal stumps and duodenal repair. Because of high mortality, prompt diagnostic evaluation and quick decision of an adequate operative treatment is necessary. Although European Society of Vascular Surgery recommendations, as a guide, are very helpful, there is no unique attitude about management of AEF, so each patient should be specifically treated.

scholarly journals Aortoduodenal fistula and associated rupture of abdominal aortic aneurysm after endoluminal stent graft repair

2003 ◽  
Vol 37 (2) ◽  
pp. 465-468 ◽  
Author(s):  
Suresh Alankar ◽  
Merle H. Barth ◽  
David D. Shin ◽  
Janice R. Hong ◽  
Wade R. Rosenberg
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Aortoduodenal Fistula ◽  
Abdominal Aortic ◽  
Stent Graft Repair ◽  
Endoluminal Stent

Antegrade thoracic endovascular aneurysm repair via the ascending aorta

2019 ◽  
Vol 27 (3) ◽  
pp. 163-171 ◽  
Author(s):  
Kosuke Fujii ◽  
Toshihiko Saga ◽  
Masahiko Onoe ◽  
Susumu Nakamoto ◽  
Toshio Kaneda ◽  
...  
Keyword(s):  
Aortic Surgery ◽  
Endovascular Aneurysm Repair ◽  
Multiple Organ ◽  
Ascending Aorta ◽  
Antegrade Approach ◽  
Abdominal Aortic ◽  
Risk Patients ◽  
Thoracic Endovascular Aneurysm Repair ◽  
Aneurysm Repair

Purpose We performed antegrade thoracic endovascular aneurysm repair via the ascending aorta in selected high-risk patients scheduled for open surgery, in whom an iliofemoral or abdominal aortic approach was not feasible. We present our initial experience with this approach. Methods Of 16 consecutive patients who underwent antegrade endovascular aneurysm repair via the ascending aorta at our institution, 3 had an emergency intervention for rupture and 3 had an urgent intervention for impending rupture or complicated aortic dissection. The procedure was scheduled in 10 patients. The median patient age was 77 years. In 13 patients, one or more concomitant procedures were performed. In 6 patients, vascular access for endovascular aneurysm repair was obtained via a branch of the replacement graft. In 10 patients, direct cannulation of the ascending aorta was carried out using 2 pursestring sutures. Results The initial success rate was 100%. Early mortality occurred in 2 (12.5%) patients because of multiple organ failure in one and heart failure in the other. No patient required a second intervention during follow-up. The mean duration of follow-up was 19 months. Conclusion The antegrade approach is a useful alternative in patients with no access suitable for endovascular aneurysm repair and who are not appropriate candidates for open conventional thoracic aortic surgery. This approach is applicable to selected patients.

Primary aortoduodenal fistula and chronic Q fever infection

2021 ◽  
Vol 14 (2) ◽  
pp. e238373
Author(s):  
Cuong Nghi Do ◽  
Ethan Oskar Mar ◽  
Beatrice Sim ◽  
David Looke
Keyword(s):  
Risk Factors ◽  
Abdominal Aortic Aneurysm ◽  
Q Fever ◽  
Case Reports ◽  
Successful Outcome ◽  
Aortoduodenal Fistula ◽  
Abdominal Aortic ◽  
Chronic Q Fever ◽  
Definitive Surgery ◽  
Animal Reservoirs

We report a case of chronic Q fever presenting with catastrophic bleeding from an infected abdominal aortic aneurysm causing a primary aortoduodenal fistula in an 80-year-old retired farmer. This presentation is rarely reported in literature and only through case reports. Early diagnosis and definitive surgery were critical to a successful outcome. Serological diagnosis of Q fever was initiated on the patient’s past exposure to animal reservoirs. Complicating the case was ongoing gastrointestinal bleeding postsurgery, with multiple endoscopies undertaken before a culprit remnant fistula was found. This case highlights the value in considering Coxiella burnetii as an underlying cause in patients with known risk factors presenting with primary aortoduodenal fistulas. Though rare, it represents a readily treatable cause.

scholarly journals Aortoduodenal fistula after endovascular stent-graft of an abdominal aortic aneurysm

2000 ◽  
Vol 31 (1) ◽  
pp. 190-195 ◽  
Author(s):  
Bertrand Janne d'Othée ◽  
Philippe Soula ◽  
Philippe Otal ◽  
Maurice Cahill ◽  
Francis Joffre ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Endovascular Stent ◽  
Aortoduodenal Fistula ◽  
Endovascular Stent Graft ◽  
Abdominal Aortic

scholarly journals A Case of Secondary Aortoduodenal Fistula, 6 Years after Abdominal Aortic Surgery

2004 ◽  
Vol 37 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Masahiro Ohira ◽  
Yoshio Miura ◽  
Midori Sasaki ◽  
Tsuyoshi Yamaguchi ◽  
Hideto Sakimoto ◽  
...  
Keyword(s):  
Aortic Surgery ◽  
Aortoduodenal Fistula ◽  
Abdominal Aortic Surgery ◽  
Abdominal Aortic

scholarly journals Fatal course of idiopathic chronic ulcerative enteritis with panenteritis and perforation: a case report and review of literature

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chang-Yeon Jung ◽  
Jung-Min Bae
Keyword(s):  
Small Bowel ◽  
Case Reports ◽  
Abdominal Distension ◽  
Multiple Organ ◽  
Case Presentation ◽  
Entire Small Bowel ◽  
Free Air ◽  
Fatal Course ◽  
History Of ◽  
Transmural Inflammation

Abstract Background Idiopathic chronic ulcerative enteritis (ICUE) is a very rare disease with high mortality. Because of clinical rarity, several small case reports have been published and there is a lack of large sample study. Preoperative definite diagnosis is difficult. Although definite treatment for ICUE is radical surgical resection, surgical decision in operative field is difficult. Case presentation A 77-year-old man came to the emergency department with complaints of a 1-day history of abdominal pain and abdominal distension. Abdominal computed tomography revealed ileus and focal free air. Laparotomy revealed multiple small bowel tiny perforations in the ileum. The serosa surface in the whole small bowel had small multiple yellowish tiny discolored lesions. Despite the presence of multiple mucosal ulcers in entire small bowel, the ileum including perforation site was resected segmentally. Microscopically, mucosal ulcers in resected small bowel demonstrated transmural inflammation, no granuloma, and no lymphoid aggregates. These features were consistent with a diagnosis of ICUE with panenteritis and perforation. After surgery, the patient’s general condition gradually aggravated. Unfortunately, the patient died of multiple organ failure on post-operative day 14. Conclusion Surgically, the decision including resection range, anastomosis or enterotomy becomes difficult in ICUE with panenteritis. According to recent 40 year’s revised data, the post-operative mortality of ICUE is about 53.4%. Although ICUE is rare, its recognition is important for appropriate diagnosis and treatment. Retrospective multicenter case studies are required to determine proper treatment and improve prognosis.

scholarly journals Stent graft infection after endovascular repair of abdominal aortic aneurysm: a case report and literature review

2020 ◽  
Vol 7 (10) ◽  
pp. 3449
Author(s):  
Alaa Sedik ◽  
Meriem Touahria ◽  
Ahmed Wahdan ◽  
Nader Twfeek ◽  
Alaa Osman
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Aortic Surgery ◽  
Late Complication ◽  
Graft Infection ◽  
Endovascular Aneurysm Repair ◽  
Emergency Laparotomy ◽  
Management Problem ◽  
Abdominal Aortic

Aortic end graft (EVAR) infection isa challenging management problem in aortic surgery with 0.2% to 0.7% incidence, which is similar to aortic graft infection after open abdominal aortic aneurysm (AAA) repair. Although much attention has been given to the more common problem of endo leak management, yet only sporadic case reports have been reported about the late complication of endograft infection. We reported a case of elderly Saudi male, known to have multiple medical problems presented to our emergency department with severe progressive abdominal pain, vomiting, and fever over the last 7 days. He was evaluated and diagnosed as septic shock due to and infected stent graft following Endovascular Aneurysm Repair of abdominal aortic aneurysm, 4 years ago, with peritonitis. He underwent emergency laparotomy and a left paraaortic abscess was drained and a part of exposed metals of the stent graft found. Other intraperitoneal abcesses were drained and abdomen closed over drains. Patient remained under ICU care, but unfortunately deteriorated and died 3 days postoperatively.

Aortoduodenal Fistula after Abdominal Aortic Stent Graft Presenting with Extremity Abscesses

Vascular ◽  
2005 ◽  
Vol 13 (05) ◽  
pp. 305 ◽  
Author(s):  
Sean P. Lyden ◽  
Eugene M. Tanquilut ◽  
Timothy J. Gavin ◽  
Julie E. Adams
Keyword(s):  
Stent Graft ◽  
Aortoduodenal Fistula ◽  
Aortic Stent Graft ◽  
Abdominal Aortic

scholarly journals The Challenges of diagnosing and managing a ruptured abdominal aortic aneurysm with primary aortoduodenal fistula.

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Greg Howgego ◽  
Dominic Howard
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Imaging Technique ◽  
Definitive Diagnosis ◽  
Clinical Suspicion ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Aortoduodenal Fistula ◽  
Abdominal Aortic ◽  
Abdominal Aortic Aneurism ◽  
Elective Repair ◽  
Multiple Step

Primary aortoduodenal fistula is a rare and highly morbid complication of an abdominal aortic aneurism (AAA). Patient X presented with a ruptured AAA complicated by a primary aortoduodenal fistula in 2016 which was treated surgically but has since suffered from repeated admissions due to sepsis as a result of ongoing graft infections.  The diagnosis of aortoduodenal fistula is complicated with no imaging technique providing a definitive diagnosis meaning that maintaining clinical suspicion is important. There is a paucity of evidence regarding how to surgically approach the repair of an aortoduodenal fistula, although there is a shift towards multiple-step procedures in elective repair.

Sign in / Sign up

Export Citation Format

Share Document