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Primary aortoenteric fistulas.

W E Wheeler1, J Hanks, V K Raman

  • 1Surgical Service, VA Medical Center, Huntington, West Virginia.

The American Surgeon
|January 1, 1992
PubMed
Summary
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Primary aortoenteric fistulas are rare, but secondary aortoenteric fistulas are a known complication of prosthetic grafts. Early diagnosis and surgical repair with antibiotics are crucial for patient survival.

Area of Science:

  • Vascular Surgery
  • Gastroenterology

Background:

  • Aortoenteric fistulas (AEF) are rare, with primary AEF documented in fewer than 200 cases.
  • Secondary AEF are a recognized complication of prosthetic grafts, occurring in 0.4–2.4% of cases.

Observation:

  • Common causes include atherosclerosis, gallstones, foreign bodies, carcinomas, and diverticular disease.
  • Diagnosis is challenging, often requiring a high index of suspicion for preoperative identification.

Findings:

  • Surgical repair is essential for survival.
  • Repair involves intestinal defect closure, vascular reconstruction (primary or extra-anatomical based on infection), and antibiotic treatment.

Implications:

  • This study discusses one of the largest series of primary AEF, highlighting the need for prompt diagnosis and tailored surgical management.

Related Experiment Videos

  • Effective management strategies are critical for improving outcomes in patients with aortoenteric fistulas.