Abdominal aortic aneurysms complicated by spontaneous iliocaval or duodenal fistulae.
Seven hundred and twenty one abdominal aortic aneurysms were treated between 1960 and 1985. Twenty one of these (2.9%) were complicated by the development of a spontaneous primary fistula, 16 (2.2%) into the vena cava or iliac veins and 5 (0.7%) into the duodenum. A correct preoperative diagnosis was made in only four instances, two aorto-caval and two aorto-duodenal fistulae. Hospital mortality was 44% for aorto-caval and 60% for aorto-duodenal fistulae. Despite the lack of a precise preoperative diagnosis in the majority of cases, the prognosis for aorto-caval fistula remained comparable to that for patients undergoing emergency surgery for uncomplicated ruptured aortic aneurysms. The mortality of spontaneous aorto-duodenal fistulae was appreciably higher and the aneurysmal contents of 4 out of these 5 cases had positive bacterial cultures.
Hickey
N C
NC
Department of Vascular Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, England.
Downing
R
R
Hamer
J D
JD
Ashton
F
F
Slaney
G
G
D000368:Aged; D001012:Aorta, Abdominal; D001019:Aortic Rupture / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D004378:Duodenal Diseases / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D007083:Iliac Artery; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014684:Venae Cavae