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Diagnosis and clinical presentation of iliac graft-enteric fistula: A case report. | LitMetric

Diagnosis and clinical presentation of iliac graft-enteric fistula: A case report.

Int J Surg Case Rep

Department of Radiology, School of Medicine, 5th Azar Hospital, Gorgan, Golestan, Iran; Golestan University of Medical Sciences, Gorgan, Golestan, Iran.

Published: November 2024

AI Article Synopsis

Article Abstract

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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532894PMC
http://dx.doi.org/10.1016/j.ijscr.2024.110460DOI Listing

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Diagnosis and clinical presentation of iliac graft-enteric fistula: A case report.

Int J Surg Case Rep

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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.

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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.

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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.

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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.

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