Endovascular repair of an actively hemorrhaging aortoduodenal fistula.
Aortoenteric fistulae require urgent definitive intervention and traditionally carry a high mortality. We describe a patient who suffered a traumatic aortic dissection following an auto versus pedestrian collision. He underwent open fenestration of his infrarenal aorta and visceral resection, complicated by abdominal sepsis and enterocutaneous fistulae. One month later he developed massive hematemesis, and endoscopic examination revealed an aortoduodenal fistula. Due to an impassable abdominal wall, a stent-graft repair was performed. This report describes the successful use of endovascular techniques to achieve immediate hemostasis in an actively hemorrhaging aortoduodenal fistula. An endovascular approach provides a valuable option in settings where a hostile abdomen precludes the traditional open technique and may serve as a bridge to later definitive repair.
Barleben
Andrew R
AR
University of California Irvine Medical Center, Orange, CA 92868, USA.
Baig
Mirza S
MS
Kubaska
Stephen M
SM
Fujitani
Roy M
RM
Gordon
Ian A
IA
Lane
John S
JS
D001012:Aorta, Abdominal / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D004378:Duodenal Diseases / Q000601:surgery*; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006396:Hematemesis / Q000601:surgery; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007412:Intestinal Fistula / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015607:Stents; D016157:Vascular Fistula / Q000601:surgery*