Intra vascular ultra sound: one more tool to diagnose aorto-duodenal fistula.
The incidence of aorto-enteric fistula in the first 5 years after abdominal aortic replacement ranges from 0.3 to 2%. We present a clinical case in which all conventional diagnostic tools failed to demonstrate the aorto-enteric fistula. A 73 year-old male suffering intermittent episodes of melena without signs and symptoms of infection was repeatedly admitted at our institution. All conventional diagnostic tools failed to show the bleeding source. Precise diagnosis was obtained using intra vascular ultrasound (IVUS). IVUS allowed prompt diagnosis of the aorto-duodenal fistula and opened the way to its endovascular treatment.
Maternini
M
M
General Surgery Department, CHUV, Lausanne, Switzerland. matteo.maternini@fhv.ch
Tozzi
P
P
Vuilleumier
H
H
Von Segesser
L K
LK
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D004378:Duodenal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D016157:Vascular Fistula / Q000000981:diagnostic imaging* / Q000209:etiology