Primary aortoenteric fistulas.
Aortoenteric fistulas were first reported in 1822. Primary aortoenteric fistulas are uncommon (less than 200 cases reported). Secondary aortoenteric fistulas are a well-recognized complication of prosthetic grafts (incidence from 0.4 to 2.4%). Atherosclerosis, gallstones, foreign bodies, carcinomas, and diverticular disease are the most common etiologies. Diagnosis is difficult with most studies being nondiagnostic. A high incidence of suspicion is required to successfully diagnosis preoperatively. Surgical repair is required for survival of the patients and should consist of the following: 1) primary closure of the intestinal defect, 2) either primary anatomical repair with a prosthetic graft or extra-anatomical vascular reconstruction, depending upon the presence or absence of infection, and 3) treatment with appropriate antibiotics. One of the largest series of primary aortoenteric fistulas from a single institution consisting of three cases secondary to aneurysmal and granulomatous disease is discussed.
Wheeler
W E
WE
Surgical Service, VA Medical Center, Huntington, West Virginia.
Hanks
J
J
Raman
V K
VK
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery; D001018:Aortic Diseases / Q000209:etiology* / Q000601:surgery; D004378:Duodenal Diseases / Q000209:etiology* / Q000601:surgery; D004386:Duodenum / Q000601:surgery; D005402:Fistula / Q000209:etiology* / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged