Aortoenteric fistulas.
During an 11-year period ending in December 1991, 36 patients with aortoenteric fistulas were assessed and treated. Twenty-five patients (69%) had previously undergone aortic reconstruction with Dacron grafts, and 11 (31%) had spontaneous aortoenteric fistulas. Of the 25 patients with secondary fistulas, 14 (56%) had undergone aortic aneurysmal rupture or multiple aortic vascular reconstructions. Preoperative diagnosis was established in only 13 (36%) of 36 patients. Remote bypass preceding removal of the infected arterial prosthesis had the least morbidity and mortality. Three primary fistulas were found in unusual locations: aortocolonic, aortobronchial, and aortoesophageal. The patient with the aortoesophageal fistulas was the fifth survivor described in the literature. The overall mortality was 56%. A positive preoperative blood culture predicted a poor outcome. There were four amputations, there due to infection of the extra-anatomical bypass. Prompt directed assessment to ensure appropriately staged operative intervention should improve survival.
Peck
J J
JJ
Department of Surgery, Good Samaritan Hospital, Portland, Ore.
Eidemiller
L R
LR
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications; D001018:Aortic Diseases / Q000503:physiopathology / Q000601:surgery*; D001019:Aortic Rupture / Q000150:complications; D016470:Bacteremia / Q000209:etiology; D001807:Blood Vessel Prosthesis; D004378:Duodenal Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000503:physiopathology; D006801:Humans; D007412:Intestinal Fistula / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology
D011093:Polyethylene Terephthalates