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Aortoenteric fistula.

R J Dachs1, J Berman

  • 1Albany Memorial Hospital, New York.

American Family Physician
|June 1, 1992
PubMed
Summary
This summary is machine-generated.

Aortoenteric fistula, a rare vascular emergency, involves abnormal connections between the aorta and intestines. Early diagnosis and intervention are critical due to high mortality rates.

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Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Medical Emergencies

Background:

  • Aortoenteric fistula (AEF) is a rare, life-threatening condition.
  • It involves abnormal connections between the aorta and the gastrointestinal tract.
  • Primary AEFs involve the native aorta, while secondary AEFs involve aortic grafts.

Purpose of the Study:

  • To review the presentation, diagnosis, and management of aortoenteric fistulas.
  • To highlight the critical need for prompt intervention in AEF cases.

Main Methods:

  • Review of clinical presentations including "herald bleed" and massive hemorrhage.
  • Diagnostic approaches such as endoscopy and computed tomographic (CT) scanning.
  • Management strategies including surgical intervention (laparotomy).

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Main Results:

  • Untreated AEF has a 100% mortality rate.
  • Clinically stable patients may undergo endoscopy; CT scans are vital for sepsis evaluation.
  • Even with surgical treatment, the mortality rate remains high at approximately 60%.

Conclusions:

  • Aortoenteric fistula is a surgical emergency requiring rapid diagnosis and treatment.
  • Prompt recognition of symptoms like herald bleed, sepsis, or abdominal pain in patients with aortic grafts is crucial.
  • Despite advances, AEF carries a significant mortality risk, underscoring the need for timely and aggressive management.