Ikeda K, Abe T, Itou M, Tamiya Y, Tanaka T, Kazui T
Department of Surgery, Sapporo Medical University School of Medicine, South 1, West 17, Chuo-ku, Sapporo 060-0061, Japan.
Ann Thorac Cardiovasc Surg. 1999 Jun;5(3):194-7.
We report a rare case of a 50-year-old woman with intermittent gastrointestinal (GI) bleeding and diagnosed as having primary aortoenteric fistula (PAEF) with inflammatory abdominal aortic aneurysm (IAAA). She was transferred to our institution with suspected PAEF as assessed by duodenoscopy and CT scan. As the patient was in shock due to massive GI-bleeding two days after admission, we performed an emergency laparotomy. The fistula was closed and the aneurysm replaced by a Woven Dacron Graft with an inter-positioning omental flap. A high index of suspicion is the most important diagnostic aid to prevent overlooking this often fatal disease.
我们报告了一例罕见病例，一名50岁女性，有间歇性胃肠道出血，被诊断为原发性主动脉肠瘘（PAEF）合并炎性腹主动脉瘤（IAAA）。经十二指肠镜检查和CT扫描评估，怀疑为PAEF，遂将她转至我院。入院两天后，患者因大量胃肠道出血而休克，我们进行了急诊剖腹手术。封闭了瘘管，并用带网膜瓣的编织涤纶移植物替换了动脉瘤。高度怀疑是预防漏诊这种常致命疾病的最重要诊断依据。
