Aortoenteric fistula. Incidence, presentation recognition, and management

Area of Science:

• Vascular Surgery
• Gastroenterology
• Medical Complications

Background:

• Aortoenteric fistulae are infrequent but severe complications following aortic reconstruction.
• Dacron grafts are commonly used in aortic repair, and their association with fistula formation requires investigation.

Purpose of the Study:

• To analyze the incidence, diagnosis, and outcomes of aortoenteric fistulae after aortic reconstruction.
• To identify optimal surgical strategies for managing this critical complication.

Main Methods:

• Retrospective analysis of 22 patients diagnosed with aortoenteric fistulae post-aortic reconstruction.
• Review of diagnostic methods, including endoscopy, and surgical interventions.
• Evaluation of patient outcomes and mortality rates.

Main Results:

• 22 patients developed aortoenteric fistulae after Dacron graft reconstruction.
• Endoscopy diagnosed fistulae in 8 of 11 examined patients.
• Most common fistula sites were the duodenum (60%), jejunum, and ileum.
• Mean time to diagnosis was 36 months; mean bleeding duration was 25 days.
• Overall surgical mortality was 77% in 21 treated patients.

Conclusions:

• Aortoenteric fistulae post-aortic reconstruction carry a high mortality rate.
• Prompt diagnosis and surgical management are essential.
• Graft resection, aortic closure, and axillofemoral bypass offer the best surgical results.