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Endovascular Treatment of Aortoduodenal Syndrome
Kun Tae Ahn1, Hiroaki Tanabe1, Mitsuhisa Kotani1
1Department of Cardiovascular Surgery, Kameda Medical Center, Chiba, Japan.
Purpose:
Duodenal obstruction caused by aneurysmal dilatation of the abdominal aorta is a rare clinical entity that is traditionally treated by open aneurysm repair, aneurysmorrhaphy, and duodenal release. We present here the case of aortoduodenal syndrome treated by endovascular therapy.
Case Report:
A 73-year-old man diagnosed simultaneously with sigmoidovesical fistula and an abdominal aortic aneurysm (AAA) underwent resection of the sigmoid colon followed by colostomy. On postoperative day 34, the patient experienced nausea and vomiting. Computed tomography revealed the AAA causing duodenal obstruction by direct compression. We chose endovascular therapy for treating the AAA rather than graft replacement because of the risk of infection by the colostomy orifice. Postoperatively, the patient reacquired the ability to eat. However, postoperative computed tomography revealed that the diameter of the AAA had not changed.
Conclusions:
We considered that the decreased intra-aneurysmal pressure caused a release of duodenal obstruction.
