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Introduction: Aorto-enteric fistula (AEF) is a life-threatening complication arising from abnormal connections between the gastrointestinal tract and major arteries. One uncommon type, iliac artery-enteric fistula (IEF), can occur following vascular interventions such as arterial stent-graft placement.
Case Presentation: We report the case of a 47-year-old male presenting with hematemesis and abdominal pain, who was diagnosed with an iliac graft-enteric fistula. Timely recognition and management were crucial for a favorable outcome.
Clinical Discussion: Diagnosing AEFs remains challenging, requiring a multidisciplinary approach and high clinical suspicion. While computed tomography angiography (CTA) is commonly used for diagnosis, its sensitivity may be limited, emphasizing the importance of integrating clinical history and findings. Management strategies vary based on etiology and patient status, with surgery being pivotal.
Conclusion: Aorto-enteric fistula, which can arise from a thrombosed graft, presents diagnostic challenges due to its rare formation. In patients with a history of vascular interventions and gastrointestinal bleeding, AEF should be considered. This case underscores the need for heightened awareness among healthcare professionals regarding AEF diagnosis and management to reduce severe morbidity, mortality, and prolonged hospital stays.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532894 | PMC |
http://dx.doi.org/10.1016/j.ijscr.2024.110460 | DOI Listing |
Int J Surg Case Rep
November 2024
Department of Radiology, School of Medicine, 5th Azar Hospital, Gorgan, Golestan, Iran; Golestan University of Medical Sciences, Gorgan, Golestan, Iran.
Introduction: Aorto-enteric fistula (AEF) is a life-threatening complication arising from abnormal connections between the gastrointestinal tract and major arteries. One uncommon type, iliac artery-enteric fistula (IEF), can occur following vascular interventions such as arterial stent-graft placement.
Case Presentation: We report the case of a 47-year-old male presenting with hematemesis and abdominal pain, who was diagnosed with an iliac graft-enteric fistula.
Clin Case Rep
August 2023
Department of Academic Surgery, Leeds Institute of Medical Research St James's University Hospital Leeds UK.
Key Clinical Message: Iliac artery-enteric fistula is a rare cause of lower GI bleeding and can cause life-threatening consequences. A high degree of clinical suspicion is needed in patients with previous aortic surgery to allow early multidisciplinary intervention.
Abstract: This case study discusses the staged management of a 78-year-old patient presenting with life-threatening lower gastrointestinal (GI) bleeding secondary to an aortoiliac graft-enteric fistula (GEF) into the sigmoid colon on the background of an adenocarcinoma and diverticular disease.
J Vasc Surg
October 2023
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN. Electronic address:
Objective: Aortic and iliac graft infections remain complex clinical problems with high mortality and morbidity. Cryopreserved arterial allografts (CAAs) and rifampin-soaked Dacron (RSD) are options for in situ reconstruction. This study aimed to compare the safety and effectiveness of CAA vs RSD in this setting.
View Article and Find Full Text PDFAnn Thorac Cardiovasc Surg
August 2007
Division of Cardiovascular Surgery, Sagamihara Kyodo Hospital, Sagamihara, Japan.
We report the case of a 64-year-old male patient with graft-enteric fistula. This complication might have been induced by sigmoid colonic ischemia resulting from injury to the mesocolon during abdominal aortic reconstruction. Although sigmoid colonic exteriorization was performed to avoid simultaneous colonic resection, graft-enteric fistula could not be prevented.
View Article and Find Full Text PDFJ Vasc Surg
October 2001
Service de Chirurgie Vasculaire et Thoracique, Hôpital Beaujon, Clichy, France.
Purpose: This prospective, observational study determined the long-term outcome in patients with abdominal aortic infection (primary or prosthetic graft) who were treated with simultaneous aortic/graft excision and cryopreserved arterial allograft reconstruction.
Methods: From April 1992 to March 2000, patients with abdominal aortic infection underwent complete or partial excision of the infected aorta/prosthetic graft and cryopreserved arterial allograft reconstruction. Arterial allografts were harvested from multiple organ donors and cryopreserved at -80 degrees C without rate-controlled freezing.
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