Stent-graft treatment for bleeding from a presumed aortoenteric fistula.
OBJECTIVE
To describe a technique for the endovascular treatment of aortoenteric fistula.


RESULTS
A 67-year-old man who had undergone aortobi-iliac grafting for aneurysmal disease 8 years previously presented with life-threatening upper gastrointestinal hemorrhage. Endoscopy after resuscitation did not identify the source of the bleeding. Computed tomographic (CT) scanning and angiography revealed pseudoaneurysm formation at the upper anastomosis 1 cm below the renal arteries. Measurements were taken for endovascular repair. Uncomplicated emergency aortic endografting for exclusion of the pseudoaneurysm was performed using a 28-mm x 3.75-cm AneuRx device. Gastrointestinal hemorrhage ceased. CT scanning at 6 months confirmed the absence of a pseudoaneurysm, and the patient remains symptom free at 18 months.


CONCLUSIONS
Endovascular treatment of aortoenteric fistula may represent a technique for treating gastrointestinal hemorrhage and for lessening the morbidity and mortality of open repair.
Grabs
A J
AJ
Department of Vascular Surgery, Concord Hospital, Sydney, Australia. spu@stvincents.com.au
Irvine
C D
CD
Lusby
R J
RJ
D000368:Aged; D017541:Aneurysm, False / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D003937:Diagnosis, Differential; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*