Document Detail


Primary aorto-enteric fistula: a rare complication of abdominal aortic aneurysm.
MedLine Citation:
PMID:  20083873     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 70-year-old lady presented with recurrent gastrointestinal bleeding and septicemia caused by multiple enteric pathogens. She was diagnosed to have primary aorto-enteric fistula (PAEF) complicating abdominal aortic aneurysm. Endovascular aneurysm repair was carried out that arrested gastrointestinal bleeding, but despite prolonged antibiotic therapy the patient died a month later of probable sepsis. PAEF refers to abnormal communication between the aorta and the intestine resulting from disease at either site; this rare condition should be suspected in patients with abdominal aortic aneurysm who present with unexplained life-threatening gastrointestinal bleeding. Computerized tomography is the most sensitive investigation. Presence of ectopic gas adjacent to or within the aorta and of contrast within the gastrointestinal tract is the pathognomonic finding. Definitive treatment consists of surgical intervention, but it is associated with high risk in the acute setting. Endovascular therapy using stent-grafts is safe and effective in arresting gastrointestinal bleeding. However, it is frequently associated with recurrent sepsis even with continued antibiotic therapy, and should be considered as a bridge to more definitive surgical repair at a later time, after optimization of the patient's condition.
Authors:
V S Thomson; K G Gopinath; E Joseph; G Joseph
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of postgraduate medicine     Volume:  55     ISSN:  0022-3859     ISO Abbreviation:  J Postgrad Med     Publication Date:    2009 Oct-Dec
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-04-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985196R     Medline TA:  J Postgrad Med     Country:  India    
Other Details:
Languages:  eng     Pagination:  267-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, CMC, Vellore, India.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Bacterial Agents / therapeutic use
Aortic Aneurysm, Abdominal / complications*,  diagnosis,  surgery
Fatal Outcome
Female
Gastrointestinal Hemorrhage / diagnosis,  etiology*,  surgery
Gram-Negative Bacterial Infections / drug therapy
Humans
Intestinal Fistula / etiology*,  surgery
Postoperative Complications
Prosthesis-Related Infections / drug therapy,  etiology
Sepsis / complications,  diagnosis
Stents / adverse effects
Tomography, X-Ray Computed
Vascular Fistula / etiology*,  surgery
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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