An iatrogenic sigmoid perforation caused by an aortobifemoral graft mimicking an advanced colon cancer.
A 74-year-old man was transferred to our hospital due to melena and syncope. He had a history of an abdominal aortic aneurysm treated with aortobifemoral grafting 15 years previously. One month before admission, he reported several episodes of melena for which he underwent repeated gastrointestinal endoscopic examinations. None of these examinations revealed the site of gastrointestinal bleeding. Aortoenteric fistulae can therefore be missed if they are not considered in the differential diagnosis of gastrointestinal bleeding due to their rarity. As a result, secondary aortoenteric fistulae should therefore be considered in any patient presenting with gastrointestinal bleeding and a history of aortic surgery.
Department of Gastroenterology and Neurology, Kagawa University Faculty of Medicine, Japan. joshin@med.kagawa-u.ac.jp
Shintaro
S
Fujihara
Hirohito
H
Mori
Hideki
H
Kobara
Noriko
N
Nishiyama
Mitsuyoshi
M
Kobayashi
Makoto
M
Oryu
Tsutomu
T
Masaki
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D003110:Colonic Neoplasms / Q000175:diagnosis; D003951:Diagnostic Errors; D005263:Femoral Artery / Q000637:transplantation; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007049:Iatrogenic Disease; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology*; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology; D008297:Male; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000209:etiology*; D058017:Vascular Grafting / Q000009:adverse effects*