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[Penetrating aortic ulcer with severe gastrointestinal bleeding]
B Certik1, V Treska, T Skalický
1Chirurgische Klinik, Universitätskrankenhaus der Karlsuniversität in Pilsen, Czech Republik. certik@fnplzen.cz
Zentralblatt Fur Chirurgie
|July 9, 2004
Summary
Primary aortoduodenal fistula, a rare cause of gastrointestinal bleeding, can result from penetrating aortic ulcers. Early diagnosis via CT angiography and surgical intervention are crucial for survival.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Radiology
Background:
- Primary aortointestinal fistula is a rare but life-threatening condition causing gastrointestinal bleeding.
- It typically involves a communication between the digestive tract and an aortic aneurysm.
- Penetrating aortic ulcers are increasingly recognized as a cause of aortoenteric fistulas.
Observation:
- A 78-year-old woman presented with massive gastrointestinal hemorrhage.
- Initial endoscopy failed to identify the source of bleeding.
- Computed tomography revealed a primary aortoduodenal fistula without an aortic aneurysm.
Findings:
- The fistula was caused by a penetrating atherosclerotic ulcer.
- Contrast-enhanced computed tomography is essential for accurate diagnosis.
- Surgical intervention is critical for patient survival.
Implications:
- Prompt diagnosis and surgical treatment of primary aortoenteric fistulas are vital.
- Penetrating aortic ulcers should be considered in cases of unexplained gastrointestinal bleeding.
- Advanced imaging like CT angiography plays a key role in identifying these rare conditions.