Navarro MS, Ramírez VJM

Language: Spanish
References: 10
Page: 1-4
PDF size: 584.62 Kb.

ABSTRACT

Male patient, 75 years old, with a history of use of ibuprofen three years ago, who consulted because of presence of hematemesis and melena, during its assessment a pulsatile mass is found, palpable at the left upper quadrant , an ultrasound is performed which documents dilated aneurysm of the abdominal aorta. The patient is examined by peripheral vascular service, and adiagnosis of aortoenteric fistula is suspected. The patient is brought to the operating room for aorto-bi-iliac substitution, aortoenteric fistulectomy with aortic tear as complication. The patient enters the intensive care unit for monitoring, ventilatory and hemodynamic support. He returns to the operating room and a duodenojejunal L – L anastomosis is performed, later on intervened afterwards for duodenum fixation and finally the abdominal cavity is closed by layers . The patient resents again bloody stools, gastroscopy documented no bleeding site. However, the patient is hemodynamically unstable, and passes by the day after.

REFERENCES

1. 1.! Brock RC. Aortic homografting: a report of six successful cases. Guys Hosp Rep. 1953;1:204-228.

2. 2.! Acosta A Karatanasopuloz R C. Haydar Levy G Martín C Paiz M, Fístula aortoentérica como causa de hemorragia digestiva en tres pacientes adultos. Med.Intensiva v.30 n.3 Barcelona abr. 2 006

3. 3.! Champion MC Sullivan SN Coles JC. Aortoenteric fistula. Incidence, presentation, recognition and management. Ann Surg. 1982;195:314-317.

4. 4.! O’Mara CS, Williams MG, Emst CB. Secondary aortoentérica fistula. A 20 year experience. Am J Surg. 1981;142:203-209.

5. 5.! Brock RC. Aortic homografting: a report of six successful cases. Guys Hosp Rep. 1953;1:204-228.

6. 6.! Lau WY. Intraoperative enteroscopy: indications and limitations. Gastrointest Endosc. 1990;36:268-271.

7. Sevastos N Rafailidis P Kolokotronis K Papadimitriou K Papatheodoridis GV. Primary aortojejunal fistula due to foreignbody: a rare cause of gastrointestinal bleeding. Eur J Gastroenterol Hepatol. 2002;14:797-800

8. 8.! Bunt TJ. Synthetic vascular grafo infection. Secondary grafo enteric erosions and grafo enteric fistulas. Surgery 94: 1, 1983.

9. 9.! Pipinos II Carr JA Haithcock BE Anagnostopoulos PV Dossa CD Reddy DJ. Secondary aorto-enteric fistula. Ann Vasc Surg 2000;14:688-696.

10. 10.! Ress AM Benacci JC Sarr MG. Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent, occult gastrointestinal bleeding. Am J Surg. 1992;163:94-98.