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A primary aorto-duodenal fistula associated with an inflammatory abdominal aortic aneurysm: a case report

Osami Honjo1, Yukio Yamada, Takashi Arata

  • 1Department of Cardiovascular Surgery, Saiseikai Imabari Hospital, Imabari, Ehime, Japan. Osami Honjo@sickkids.ca

Acta Medica Okayama
|September 13, 2005
PubMed

Insights

Primary aorto-enteric fistula (PAEF), a rare complication of abdominal aortic aneurysms (AAA), can be successfully treated with emergent surgery. This case highlights effective surgical management and uneventful recovery for this serious condition.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Medical Imaging

Background:

  • Primary aorto-enteric fistula (PAEF) is a rare but life-threatening complication of abdominal aortic aneurysms (AAA).
  • Inflammatory AAA presents unique challenges in diagnosis and management.
  • Recurrent gastrointestinal bleeding is a critical sign necessitating urgent investigation.

Observation:

  • A 52-year-old male presented with recurrent hematemesis, indicating significant upper gastrointestinal bleeding.
  • Computed tomography (CT) revealed a sealed rupture of an AAA adjacent to the duodenum.
  • Surgical exploration identified a coin-sized PAEF.

Findings:

  • Emergent surgical intervention involved in-situ replacement of the affected aorta with a Dacron graft.
  • Histological examination confirmed the presence of an inflammatory AAA.
  • The patient experienced an uneventful postoperative recovery with no signs of infection over a 3-year follow-up.

Implications:

  • This case underscores the importance of prompt diagnosis and surgical intervention for PAEF associated with inflammatory AAA.
  • Successful management can lead to favorable long-term outcomes, even in complex cases.
  • Further discussion on etiologic factors and surgical strategies for this unusual entity is warranted.

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