Detection of an aortoenteric fistula in a patient with intermittent bleeding.
BACKGROUND
A 57-year-old male with an aortobifemoral bypass graft presented to a gastroenterology clinic with a 3-month history of intermittent hematemesis, melena and fever. The patient had received antibiotic therapy 2 months before for the same symptoms; however, following brief regression ( approximately 3 weeks) the symptoms had returned.


METHODS
Physical examination; analysis of full blood count; measurement of erythrocyte sedimentation rate, C-reactive protein levels, liver enzymes, electrolytes, renal function, serum cholesterol and serum triglyceride; HIV serology; blood, sputum, urine and stool culture analysis; performance of esophagogastroduodenoscopy, colonoscopy, abdominal ultrasonography and multidetector CT scanning.


METHODS
Aortoenteric fistula with an inflammatory mass surrounding the aortobifemoral bypass graft.


RESULTS
Laparotomy with removal of the aortobifemoral bypass graft, performance of an extra-anatomic right axillofemoral bypass graft and an extra-anatomic right-left femorofemoral bypass graft.
Odemiş
Bülent
B
Department of Gastroenterology, Diskapi Yildirim Beyazit Education and Training Hospital, Diskapi, Ankara, Turkey.
Başar
Omer
O
Ertuğrul
Ibrahim
I
Ibiş
Mehmet
M
Yüksel
Ilhami
I
Uçar
Engin
E
Arda
Kemal
K
D001018:Aortic Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D006396:Hematemesis / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D008551:Melena / Q000209:etiology*; D008875:Middle Aged; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery