[Paraplegia after surgical treatment of primary aorto-duodenal fistula].
A 68-year-old patient with chronic cirrhosis underwent surgical repair of the subrenal abdominal aorta presenting an aorto-duodenal fistula. The fistula was considered to be a primary fistula because it occurred without prior surgery and because the aorta had ruptured without formation of an aneurysm. The postoperative period was complicated by paraplegia further compromising the outcome in this severe condition. In general, there are several problems involved in the management of aorto-duodenal fistulae. Neither computed tomography of the abdomen nor gastroduodenal endoscopy are able to provide the diagnosis in all cases before surgery. Surgical treatment is most often conducted in an emergency setting requiring repair of both the digestive tract and of the vascular lesions. It is also important to recognize the risk of neurological events occurring intra-operatively. Prognosis is usually poor.
Picard
E
E
Service de Chirurgie thoacique et cardio-vasculaire, Hôpital Arnaud de Villeneuve, Montpellier.
Demaria
R
R
Branchereau
P
P
Meunier
J P
JP
Frapier
J M
JM
Chaptal
P A
PA
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000401:mortality / Q000601:surgery*; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000401:mortality / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000401:mortality / Q000601:surgery*; D010264:Paraplegia / Q000209:etiology*; D011183:Postoperative Complications; D013116:Spinal Cord / Q000098:blood supply; D014057:Tomography, X-Ray Computed
Paraplégie après traitement chirurgical d'une fistule aorto-duodénale primaire.