Aorto-duodenal fistulas represent a rare but highly dangerous complication following reconstructive aortic interventions. They may be the source of severe gastrointestinal hemorrhages. The recognition of cause and localization of the latter may be difficult. Only an immediate diagnosis permits urgent surgical intervention and may prevent the otherwise fatal outcome. The importance of an early diagnosis is underlined by two case reports.
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Management of Aorto-Duodenal Fistula: Case Series and Technical Notes.
Ann Ital Chir
January 2025
Chirurgia Vascolare, PO Belcolle, ASL Viterbo, 01100 Viterbo, Italy.
Aorto-duodenal fistula (ADF) is a rare clinical condition characterized by abnormal communication between the 3rd or 4th portion of the duodenum and the aorta, typically associated with aneurysmal disease. The incidence of ADF is expected to increase, however, there remains a lack of consensus on the optimal approach for intestinal restoration. In this study, we present three cases of ADF and their respective treatments using three distinct surgical techniques.
View Article and Find Full Text PDFSecondary aorto-duodenal fistula: a diagnostic challenge in a patient with fever and anemia.
Rev Esp Enferm Dig
March 2024
Gastroenterology, Hospital Clínico Universitario de Valladolid.
A 69-year-old male, three years post-endovascular exclusion for an abdominal aortic aneurysm, presented with asthenia and fever. An abdominal CT scan showed no gastrointestinal tract communications, abscess, or contrast extravasation. Tc-99m-HMPAO-labeled leukocytes scintigraphy with SPECT/CT revealed increased uptake on the posterior surface of the aortic graft, along with air bubbles in its right iliac limb.
View Article and Find Full Text PDFKey Clinical Message: Brucella aortitis should be one of the differential diagnoses of inflammatory aortic aneurysms. In situ repair of intermittent aortoenteric fitulae and repair of infrarenal aortic aneurysm with synthetic graft can be used in clean scarred fistulae.
Abstract: Arterial aneurysms are very rare complications of Brucella infection.
Primary aorto-duodenal fistula (PADF) is a rare life-threatening condition consisting in a direct communication between the abdominal aorta and the gastrointestinal tract without any previous vascular intervention. PADF results most commonly from an abdominal aortic aneurism (AAA) or aortic bacterial/mycotic infection, with the fistula forming between the native aorta and the third or fourth portion of the duodenum. Symptoms are nonspecific and the diagnosis is often delayed after AAA rupture with high rate of morbidity and mortality.
View Article and Find Full Text PDFIt Is Not Always Diverticular Bleeding: Fatal Subtle Primary Aorto-Duodenal Fistula Associated With Abdominal Aortic Aneurysm.
Cureus
January 2023
Gastroenterology and Hepatology, Mid-America Gastro-Intestinal Consultants, Kansas City, USA.
Primary aorto-duodenal fistula (PADF) is a connection between the aorta and duodenum without prior aortic surgery. We present a case of an 80-year-old female who presented with hematochezia. She was vitally stable but later developed a large episode of hematemesis followed by cardiac arrest.
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