Successful management of latrogenic aortoduodenal fistula by intraaortic endovascular stent-graft and duodenal diversion.
Aortoduodenal fistula is usually fatal if not treated promptly. Long-term results are also not always satisfactory. A 53-year-old female patient suffered from massive hematemesis and shock due to an iatrogenic aortoduodenal fistula which was made during a laparoscopic total colectomy. Immediate closure of fistula with duodenal diversion by occlusion of duodenal lumen proximal to the fistula, bilateral truncal vagotomy and pyloroduodenojejunostomy were performed. Endoluminal aortic stent graft was inserted 3 days later. The patient remained disease-free 3 years after operation. With a prompt diagnosis, duodenal diversion with endoluminal aortic stent may be a better option for iatrogenic aortoduodenal fistula.
Yu
Cheng-Chan
CC
Department of Surgery, Cardiology, Taichung Veterans General Hospital, Taiwan.
Lee
Wen-Lieng
WL
Ho
Wei-Meng
WM
Wu
Cheng-Chung
CC
Liu
Tse-Jia
TJ
P'eng
Fang-Ku
FK
D000800:Angioplasty, Balloon; D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003082:Colectomy; D003110:Colonic Neoplasms / Q000601:surgery*; D003131:Combined Modality Therapy; D004378:Duodenal Diseases / Q000601:surgery*; D004385:Duodenostomy; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007412:Intestinal Fistula / Q000601:surgery*; D007582:Jejunostomy; D010535:Laparoscopy; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011706:Pyloric Antrum / Q000601:surgery; D012086:Reoperation; D015607:Stents; D015167:Vagotomy, Truncal; D016157:Vascular Fistula / Q000601:surgery*