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[Aorto-intestinal fistulas. 4 case reports].

G Bansky, C Valli, W H Häcki

    Schweizerische Medizinische Wochenschrift
    |September 15, 1984
    PubMed
    Summary

    Aorto-enteric fistula, a rare condition, can be primary (aneurysm rupture or tumor) or secondary (post-surgery). Early diagnosis and surgical intervention, including graft resection and axillo-bifemoral anastomosis, improve prognosis.

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    Area of Science:

    • Vascular Surgery
    • Gastroenterology
    • Oncology

    Background:

    • Aorto-enteric fistula is a rare but serious complication involving abnormal communication between the aorta and the gastrointestinal tract.
    • Understanding the distinct etiologies of primary and secondary fistulas is crucial for diagnosis and management.

    Observation:

    • Primary fistulas arise from abdominal aortic aneurysms or tumor infiltration.
    • Secondary fistulas typically develop as late complications following aortic reconstructive surgery.
    • Endoscopic findings aided diagnosis in two reported cases.

    Findings:

    • Graft infection plays a significant pathogenetic role in secondary aorto-enteric fistulas.
    • Tumor infiltration of the aorta and intestinal wall is another primary cause.
    • Prompt surgical intervention is key to managing this condition.

    Implications:

    • The prognosis for aorto-enteric fistula is generally poor but can be significantly improved.
    • Combining graft resection with axillo-bifemoral bypass offers a potentially life-saving strategy.
    • Further research into early diagnostic markers and optimized surgical techniques is warranted.

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