[Aorto-intestinal fistula as a possible cause of endoscopically undetermined gastrointestinal hemorrhage].
Primary aorto-enteric fistulae are rare, mostly described as atypical first manifestation of an abdominal aortic aneurysm. Spread of elective aortic surgery led to increased appearance of secondary aorto-enteric fistulae as a typical postoperative complication. Gastrointestinal bleeding with endoscopical unclear findings in a patient with aortic aneurysm or history of aortic repair points towards an aorto-enteric fistula. While preoperative diagnosis is not possible in most instances, the proof of an anastomotic aneurysm and/or aortic graft infection hardens the suspected diagnosis of an aorto-enteric fistula decisively. The finding of coincidental mucosal lesions at gastroscopy may not mislead to give up the exclusion of an aorto-enteric fistula, possibly by explorative laparotomy, if suspicion is well-founded. In the present article nine cases of aorto-enteric fistulae treated at the Surgical University Clinic Würzburg between 1982 and 1993 are analyzed retrospectively. Topical questions of diagnosis and therapy are discussed.
Franke
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Chirurgische Universitätsklinik Würzburg.
Debus
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ES
Voit
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D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000209:etiology* / Q000601:surgery; D001019:Aortic Rupture / Q000601:surgery; D001807:Blood Vessel Prosthesis; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; 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; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000150:complications; D012086:Reoperation; D012189:Retrospective Studies; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000601:surgery
Aortointestinale Fistel als mögliche Ursache einer endoskopisch unklaren gastrointestinalen Blutung.