[Conservative treatment of an aortoduodenal fistula after paraaortic lymphadenectomy in hepatobiliary malignancy surgery with aortic endoprosthesis].
Lower gastrointestinal bleeding from a primary aortoduodenal fistula is unusual and usually fatal. Postoperative aortoduodenal fistula after biliary surgery is a very rare complication. We report hence a 69-year-old female patient who underwent a main bile duct resection with extended paraaortic lymphadenectomy for a cholangiocarcinoma. Acute melena with hemoglobin drop occurred on postoperative day 24. Initial CT-scan showed an aortic pseudoaneurysm with aortoduodenal fistula. An aortic endoprosthesis with endoscopic drainage of periaortic collections allowed successful treatment.
Fuks
D
D
Service de chirurgie digestive, fédération médicochirurgicale de pathologies digestives, CHU Nord-Amiens, place Victor-Pauchet, Amiens cedex 1, France.
Humbert-Claude
C
C
Deguines
J-B
JB
Sabbagh
C
C
Browet
F
F
Hajji
H
H
Blampain
S
S
Reix
B
B
Chatelain
D
D
Reix
T
T
Régimbeau
J-M
JM
D000368:Aged; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000209:etiology* / Q000628:therapy*; D001650:Bile Duct Neoplasms / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D001807:Blood Vessel Prosthesis; D018281:Cholangiocarcinoma / Q000601:surgery; D004378:Duodenal Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008197:Lymph Node Excision / Q000009:adverse effects*; D016157:Vascular Fistula / Q000209:etiology* / Q000628:therapy*