Diagnosis and management of graft-enteric fistulae.
During a 7-year period 20 patients underwent operation for a graft-enteric fistula after implantation of an intra-abdominal vascular prosthesis months or years before. Eighteen patients had gastrointestinal blood loss as their first symptom; 12 were in shock on admission. Fourteen patients had a fistula between the proximal anastomosis and the duodenum. Graft excision followed by axillobifemoral bypass was performed in 10 patients and four patients underwent local repair. A fistula between the distal anastomosis and the bowel was found in the remaining six patients and a local repair was carried out. Proximal graft-enteric fistula carries a particularly high postoperative mortality rate of more than 50 per cent.
Tilanus
H W
HW
Department of Surgery, University Hospital Dijkzigt, Erasmus University Hospital Rotterdam, The Netherlands.
Terpstra
O T
OT
de Smit
P
P
van Urk
H
H
Veen
H F
HF
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004378:Duodenal Diseases / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*