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Primary aortoenteric fistula
S J F Saers1, M R M Scheltinga
1Department of Surgery, Máxima Medical Centre Veldhoven, de Run 4600, 5500 MB Veldhoven, The Netherlands.
The British Journal of Surgery
|February 3, 2005
Summary
Primary aortoenteric fistula (PAEF) is a rare condition. Early diagnosis using CT and endovascular repair have improved outcomes for patients with PAEF, a potentially fatal condition.
Area of Science:
- Vascular Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Primary aortoenteric fistula (PAEF) is a rare and often fatal condition if not diagnosed promptly.
- This study examines changes in PAEF management and survival over time.
Purpose of the Study:
- To evaluate temporal trends in the diagnosis, management, and survival rates of primary aortoenteric fistula (PAEF).
Main Methods:
- A systematic literature review of PAEF cases diagnosed between January 1994 and December 2003.
- Comparison of findings with previously published reviews of PAEF.
Main Results:
- The classic PAEF triad was present in only 11% of 81 patients.
- Aneurysmal aorta was the most common cause, with 94% of cases preceded by recurrent gastrointestinal bleeding.
- Computed tomography (CT) demonstrated superior diagnostic accuracy compared to other modalities.
- Lower operative mortality rates were observed in recent years, potentially due to improved perioperative care and endovascular techniques.
Conclusions:
- Gastrointestinal bleeding with a negative endoscopy in patients with an aneurysmal aorta should raise suspicion for PAEF, necessitating urgent CT evaluation.
- Endovascular repair presents a promising treatment option for PAEF.