title: Endovascular treatment of a small infrarenal abdominal aortic aneurysm causing duodenal obstruction: Case report and literature review.
abstract: Duodenal obstruction caused by abdominal aortic aneurysm was first described by Osler in 1905 and is named "aortoduodenal syndrome." This condition has always been treated by open surgical repair. We report the first case of aortoduodenal syndrome successfully treated by endovascular aneurysm repair. A 74-year-old male patient referred to our hospital complaining postprandial vomit, reporting a consistent weight loss in the latest weeks. Enhanced computed tomography scans showed a small saccular abdominal aortic aneurysm compressing duodenum and inferior vena cava without any other evident pathological finding. As the patient underwent a successful endovascular treatment of the abdominal aortic aneurysm, symptoms immediately resolved so that he started back to feed and progressively gained body weight. Despite aortoduodenal syndrome is generally caused by large abdominal aortic aneurysm, this condition has to be suspected also in case of small abdominal aortic aneurysm. Differently from what has been reported in literature, endovascular aneurysm repair could be effective in the treatment of aortoduodenal syndrome.
authors.affiliation: Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", University of Rome, Rome, Italy miandra@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Esposito
authors.affiliation: Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", University of Rome, Rome, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Menna
authors.affiliation: Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", University of Rome, Rome, Italy.
authors.forename: Wassim
authors.initials: W
authors.lastname: Mansour
authors.affiliation: Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", University of Rome, Rome, Italy.
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Sirignano
authors.affiliation: Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", University of Rome, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Capoccia
authors.affiliation: Vascular and Endovascular Surgery Division, Department of Surgery "Paride Stefanini", University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Speziale
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000601:surgery*; D004386:Duodenum / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D011859:Radiography; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Aortoduodenal syndrome; abdominal aortic aneurysm; bilious emesis; duodenal compression; endovascular aneurysm repair