Recurrent aortoduodenal fistula.
Aortoenteric fistula is defined as a communication between the aorta and an adjacent loop of the bowel and is often the cause of devastating upper gastrointestinal tract bleeding with only few survivors. According to the etiology, the aortoenteric fistulas are classified as primary aortoenteric fistula or secondary aortoenteric fistula (SAEF) after previous aortic surgery. The recurrence of a fistula on a previous SAEF is defined as recurrent aortoenteric fistula and is reported only in a few rare cases occurring within an unpredictable period from the previous surgical treatment. We describe a unique case of recurrent aortoenteric fistula, in which the relationship with recurrence consisted of the presence of the metallic clips of a stapled suture to close the duodenal wall during the previous SAEF repair. A review of the published data on this subject was performed to analyze the clinical features, the overall results, the risk factors of recurrence, and the main technical points of surgical treatment to prevent it.
Department of Surgical Science, Transplantation and Advanced Technologies, Cannizzaro Hospital, University of Catania, Via Messina 354, Catania, Italy. glagreca@unict.it
Gaetano
G
La Greca
Francesco
F
Barbagallo
Salvatrice
S
Gagliardo
Saverio
S
Latteri
Vincenzo
V
Scala
Maria
M
Sofia
Domenico
D
Russello
D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D017792:Surgical Stapling / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000601:surgery*