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Technical Aspects of the Mouse Aortocaval Fistula
Published on: July 11, 2013
Secondary aortoduodenal fistulae
E Bastounis1, E Papalambros, V Mermingas
1First Department of Surgery, Medical School, University of Athens, Laikon Hospital, Greece.
The Journal of Cardiovascular Surgery
|November 14, 1997
Summary
Secondary aortoenteric fistula (SAF) is a rare, fatal complication after aortic surgery. Early diagnosis and surgical intervention, including graft removal and repair, are crucial for survival, though mortality remains high.
Area of Science:
- Vascular Surgery
- Gastrointestinal Surgery
Background:
- Secondary aortoenteric fistula (SAF) is a rare but life-threatening complication following reconstructive aortoiliac surgery.
- Diagnosis and management of SAF present significant clinical challenges.
Purpose of the Study:
- To present a series of secondary aortoduodenal fistula cases.
- To discuss the clinical presentation, treatment, and outcomes of SAF.
Main Methods:
- Retrospective review of nine cases of secondary aortoduodenal fistulae between 1980 and 1992.
- Description of surgical management, including graft removal, duodenal repair, and revascularization strategies.
Main Results:
- The primary symptom was upper gastrointestinal bleeding, with a mean interval of 32 months post-aortic surgery.
- Surgical management involved graft explantation and duodenal closure; some patients required revascularization.
- Postoperative mortality was 33% (3 out of 9 patients).
Conclusions:
- Upper gastrointestinal bleeding in patients with prior abdominal vascular surgery warrants high suspicion for SAF.
- Exploratory laparotomy is essential to confirm or exclude SAF.
- Prompt diagnosis and aggressive surgical management are critical, but outcomes remain guarded.
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