title: Secondary aortoduodenal fistula complicating aortic grafting, as a cause of intermittent chronic intestinal bleeding.
abstract: Intermittent intestinal bleeding persisted in a 77-year-old male, who had undergone grafting for abdominal aortic aneurysm. Each attack lasted for a few weeks and spontaneously resolved. Only a minute abnormality was found in the third portion of the duodenum; barium studies showed a segmental narrowing, but endoscopy disclosed only a small erosion in that portion. Massive and fatal gastrointestinal hemorrhage broke out 6 months after the onset of bleeding. Autopsy revealed an adhesion area with a small fistula formation between the duodenum and aorta. Even slight endoscopic findings should be considered suggestive of aortoenteric fistula in patients after aortic surgery.
authors.affiliation: Department of Internal Medicine, Ashiya Municipal Hospital, Hyogo.
authors.forename: M
authors.initials: M
authors.lastname: Yabu
authors.forename: S
authors.initials: S
authors.lastname: Himeno
authors.forename: Y
authors.initials: Y
authors.lastname: Kanayama
authors.forename: T
authors.initials: T
authors.lastname: Furubayashi
authors.forename: K
authors.initials: K
authors.lastname: Kiriyama
authors.forename: Y
authors.initials: Y
authors.lastname: Nagasawa
authors.forename: R
authors.initials: R
authors.lastname: Takakura
authors.forename: T
authors.initials: T
authors.lastname: Katata
authors.forename: N
authors.initials: N
authors.lastname: Iwao
authors.forename: A
authors.initials: A
authors.lastname: Orino
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000175:diagnosis / Q000209:etiology*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology*; D004384:Duodenoscopy; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology*