title: Intra-Aortic Balloon Occlusion (IABO) may be useful for the management of secondary aortoduodenal fistula (SADF): A case report.
abstract: BACKGROUND
  Secondary aortoduodenal fistula (SADF) is a rare but life-threatening complication after aortic reconstruction. Although a number of reports describing treatments for SADF have been published, the optimal management is unclear. A review of the literature suggested methods of reconstruction, control of bleeding, and reduction of infection in the management of SADF. The most important factor for acute intervention is controlling the bleeding from the fistula. We report one case treated using intra-aortic balloon occlusion (IABO) for SADF.
  
  
  METHODS
  We describe a case of secondary aortoduodenal fistula that occurred seven years following aortobifemoral reconstruction for abdominal aortic aneurysm.
  
  
  CONCLUSIONS
  Early control of bleeding is essential for survival of the patient. Emergency laparotomy or endovascular stenting frequently have been chosen as interventions, although each approach has significant limitations. Emergency laparotomy for patients with hemodynamic instability may create excessive physiologic stress, and endovascular stenting may not be available at every surgical facility. The use of IABO for cases of intraperitoneal bleeding due to trauma has been previously described. IABO is relatively easy to implement, and enabled us to control the bleeding from the aorta more rapidly than other strategies.
  
  
  CONCLUSIONS
  Based on a review of the literature and our own experience, IABO should be considered as one option for the management of SADF.
authors.affiliation: Department of Surgery, Japan.
authors.forename: Kokichi
authors.initials: K
authors.lastname: Miyamoto
authors.affiliation: Department of Emergency, Okayama Saiseikai General Hospital, 2-25 Kokutaicho, kita-ku, Okayama 7008511, Japan. Electronic address: moto178@yahoo.co.jp.
authors.forename: Mototaka
authors.initials: M
authors.lastname: Inaba
authors.affiliation: Department of Surgery, Japan. Electronic address: trkojima0507@yahoo.co.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Kojima
authors.affiliation: Department of Surgery, Japan. Electronic address: niguma@saiseidr.jp.
authors.forename: Takefumi
authors.initials: T
authors.lastname: Niguma
authors.affiliation: Department of Surgery, Japan. Electronic address: tsmimura@saiseidr.jp.
authors.forename: Tetsushige
authors.initials: T
authors.lastname: Mimura
keywords: Control of bleeding; Intra-aortic balloon occlusion; Secondary aortoduodenal fistula