Secondary aortoduodenal fistula complicating aortic grafting, as a cause of intermittent chronic intestinal bleeding.
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.
Yabu
M
M
Department of Internal Medicine, Ashiya Municipal Hospital, Hyogo.
Himeno
S
S
Kanayama
Y
Y
Furubayashi
T
T
Kiriyama
K
K
Nagasawa
Y
Y
Takakura
R
R
Katata
T
T
Iwao
N
N
Orino
A
A
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*