Unexpected double-primary aortoenteric fistula resulting in massive bleeding after induction of anesthesia.
We report a case of a patient with a double-primary aortoenteric fistula with an abdominal aortic aneurysm. A 75-year-old man was taken to the operating room for the repair of an abdominal aortic aneurysm and a suspected aortoenteric fistula between the aorta and sigmoid colon. Sudden onset of massive bleeding through the nasogastric tube occurred after the induction of anesthesia. Surgical exploration confirmed an unexpected aortoduodenal fistula. Primary aortoenteric fistula is extremely rare and difficult to diagnose, and may cause fatal bleeding. The possibility of the presence of aortoenteric fistula, including multiple types, should be considered in the anesthetic management of abdominal aortic aneurysm.
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, 1-10 Ami-dong, Seo-gu, Busan, 602-739, Korea.
Jung Min
JM
Hong
Hae Kyu
HK
Kim
Eun Soo
ES
Kim
Hee Young
HY
Kim
Nam Won
NW
Kim
Ji Young
JY
Yoon
D000368:Aged; D000758:Anesthesia; D001012:Aorta, Abdominal; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D001018:Aortic Diseases / Q000150:complications* / Q000628:therapy; D004378:Duodenal Diseases / Q000150:complications / Q000628:therapy; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications* / Q000628:therapy; D007431:Intraoperative Complications / Q000209:etiology* / Q000628:therapy; D008297:Male; D010347:Patient Care Planning; D012810:Sigmoid Diseases / Q000150:complications / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000150:complications* / Q000628:therapy