title: Aortogastric Fistula Due to a Penetrating Atherosclerotic Aortic Ulcer.
abstract: Penetrating aortic ulcer (PAU) is an atherosclerotic lesion with ulceration that penetrates the internal elastic lamina of the aortic wall. PAUs are classified as a category of acute aortic syndrome and have a reported rupture rate of up to 38%. To our knowledge, there is no prior published report of a PAU causing an aortogastric fistula. With the goal of raising awareness of this potentially catastrophic complication, we present herein a case of a PAU that ruptured into the gastric fundus, resulting in massive bleeding. The diagnosis was confirmed by computed tomography angiography, and thoracic endovascular aortic repair was used to control bleeding. Unfortunately, the patient did not survive the severe hypovolemic shock.
authors: Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: mbdalio@usp.br.
authors: Marcelo Bellini
authors: MB
authors: Dalio
authors: Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors: Nei Rodrigues Alves
authors: NR
authors: Dezotti
authors: Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors: Maurício Serra
authors: MS
authors: Ribeiro
authors: Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors: Edwaldo Edner
authors: EE
authors: Joviliano
authors: Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors: Carlos Eli
authors: CE
authors: Piccinato
mesh_terms: D000368:Aged; D001018:Aortic Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005747:Gastric Fistula / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D016157:Vascular Fistula / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery