Abstract
Twenty-two patients developed one or more aortoenteric fistulae following aortic reconstruction with a dacron graft. Endoscopy was performed on 11 of these patients on 17 occasions and a preoperative diagnosis was made in eight patients. Fistulous communication was most common between the aorta and duodenum (60%), and a further 30% penetrated into the jejunum and ileum. The mean period from operation to time of diagnosis was 36 months and the mean length of bleeding was 25 days, allowing ample time for preoperative evaluation. Surgery was performed on 21 of the 22 patients with an overall mortality of 77%. The best surgical results were obtained with graft resection, closure of the aorta, and maintenance of circulation by an axillofemoral graft.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BROCK R. C. Aortic homografting; a report of six successful cases. Guys Hosp Rep. 1953;102(3):204–228. [PubMed] [Google Scholar]
- Baker M. S., Fisher J. H., van der Reis L., Baker B. H. The endoscopic diagnosis of an aortoduodenal fistula. Arch Surg. 1976 Mar;111(3):304–304. doi: 10.1001/archsurg.1976.01360210098023. [DOI] [PubMed] [Google Scholar]
- Becker R. M., Blundell P. E. Infected aortic bifurcation grafts: experience with fourteen patients. Surgery. 1976 Nov;80(5):544–549. [PubMed] [Google Scholar]
- Brand E. J., Sivak M. V., Jr, Sullivan B. H., Jr Aortoduodenal fistula: endoscopic diagnosis. Dig Dis Sci. 1979 Dec;24(12):940–944. doi: 10.1007/BF01311950. [DOI] [PubMed] [Google Scholar]
- Busuttil R. W., Rees W., Baker J. D., Wilson S. E. Pathogenesis of aortoduodenal fistula: experimental and clinical correlates. Surgery. 1979 Jan;85(1):1–13. [PubMed] [Google Scholar]
- Elliott J. P., Jr, Smith R. F., Szilagyi D. E. Proceedings: Aortoenteric and paraprosthetic-enteric fistulas. Problems of diagnosis and management. Arch Surg. 1974 Apr;108(4):479–490. doi: 10.1001/archsurg.1974.01350280083014. [DOI] [PubMed] [Google Scholar]
- LEVY M. J., TODD D. B., LILLEHEI C. W., VARCO R. L. AORTICOINTESTINAL FISTULAS FOLLOWING SURGERY OF THE AORTA. Surg Gynecol Obstet. 1965 May;120:992–996. [PubMed] [Google Scholar]
- Mir-Madjlessi S. H., Sullivan B. H., Jr, Farmer R. G., Beven E. G. Endoscopic diagnosis of aortoduodenal fistula. Gastrointest Endosc. 1973 May;19(4):187–188. doi: 10.1016/s0016-5107(73)73997-3. [DOI] [PubMed] [Google Scholar]
- Puglia E., Fry P. D. Aortoenteric fistulas: a preventable problem? Can J Surg. 1980 Jan;23(1):74–76. [PubMed] [Google Scholar]
- Rosenthal D., Deterling R. A., Jr, O'Donnell T. F., Jr, Callow A. D. Positive blood culture as an aid in the diagnosis of secondary aortoenteric fistula. Arch Surg. 1979 Sep;114(9):1041–1044. doi: 10.1001/archsurg.1979.01370330063012. [DOI] [PubMed] [Google Scholar]
- Skibba R. M., Greenberger N. J., Hardin C. A. Paraprosthetic-enteric fistula. Role of Preoperative endoscopy. Am J Dig Dis. 1975 Nov;20(11):1081–1086. doi: 10.1007/BF01071199. [DOI] [PubMed] [Google Scholar]
- Thompson W. M., Jackson D. C., Johnsrude I. S. Aortoenteric and paraprosthetic-enteric fistulas: radiologic findings. AJR Am J Roentgenol. 1976 Aug;127(2):235–242. doi: 10.2214/ajr.127.2.235. [DOI] [PubMed] [Google Scholar]
- Wierman W. H., Strahan R. W., Spencer J. R. Small bowel erosion by synthetic aortic grafts. Am J Surg. 1966 Nov;112(5):791–797. doi: 10.1016/0002-9610(66)90125-5. [DOI] [PubMed] [Google Scholar]