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Primary aortoenteric fistula

H Barned1, P R Fletcher, R Carpenter

  • 1Department of Surgery, U.W.I., Jamaica.

The West Indian Medical Journal
|September 1, 1995
PubMed
Summary
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Primary aortoenteric fistulae are a rare complication of abdominal aortic aneurysms. This study highlights the serious gastrointestinal bleeding risk and high mortality associated with these fistulae, emphasizing prompt diagnosis and treatment.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Surgical Complications

Background:

  • Abdominal aortic aneurysms (AAAs) are a significant vascular condition.
  • Aortoenteric fistulae (AEF) are rare but life-threatening complications of AAAs.
  • Understanding the presentation and outcomes of AEF is crucial for patient management.

Purpose of the Study:

  • To report the incidence and clinical features of primary aortoenteric fistulae in patients undergoing aneurysmorrhaphy for abdominal aortic aneurysms.
  • To analyze the presentation, diagnosis, and outcomes of patients with AEF.

Main Methods:

  • Retrospective review of 138 patients treated for abdominal aortic aneurysms over an eleven-year period.
  • Identification and analysis of cases diagnosed with primary aortoenteric fistulae.

Related Experiment Videos

  • Review of clinical presentation, surgical findings, and patient outcomes.

    • Main Results:

    • Six male patients (aged 60-74 years) developed primary aortoenteric fistulae.
    • Common presentations included gastrointestinal bleeding with abdominal swelling or hemorrhage discovered during laparotomy.
    • Surgical confirmation was achieved in five patients; one was confirmed at autopsy.
    • Mortality rate was 33% (2 out of 6 patients), with deaths due to hemorrhage and sepsis with multi-organ failure.

    Conclusions:

    • Primary aortoenteric fistulae are a rare but severe complication of abdominal aortic aneurysms.
    • Gastrointestinal bleeding is a key presenting symptom, often associated with abdominal pain.
    • High mortality underscores the need for rapid diagnosis and intervention in suspected cases.