Gastroduodenal artery-duodenal fistula: a complication of continuous floxuridine (FUDR) infusion into the gastroduodenal artery.
This case report describes a patient who for 31 months has received regional intrahepatic chemotherapy from a continuous infusion pump and who developed a gastroduodenal artery-duodenal fistula, a previously unreported complication of regional infusion therapy. The patient presented with signs and symptoms of upper gastrointestinal bleeding. The clinical evaluation and management are described. An angiogram was performed through the auxillary septum to identify the source of bleeding. The possible etiologic factors in this case are discussed. We believe that this complication will continue to be rare, but health care providers should be aware of its presentation and its preferred method of evaluation and management.
Kernstine
K H
KH
Department of Surgery, University of Minnesota, Minneapolis.
Kryjeski
S R
SR
Hall
L J
LJ
Larson
R E
RE
Saylor
H L
HL
Fortuny
I E
IE
D000230:Adenocarcinoma / Q000188:drug therapy; D001158:Arteries; D004378:Duodenal Diseases / Q000209:etiology*; D004386:Duodenum / Q000098:blood supply*; D005402:Fistula / Q000209:etiology*; D005467:Floxuridine / Q000008:administration & dosage; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007412:Intestinal Fistula / Q000209:etiology*; D008113:Liver Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000098:blood supply*
D005467:Floxuridine