Chaudhary Nadeem A, Saymeh Layth, Vongthavaravat Verapan, Harty Richard F
Section of Gastroenterology, University Hospital, 7 North Pavilion, Room 526, P.O. Box 26307, OKC, OK 73216, USA.
J Okla State Med Assoc. 2003 Nov;96(11):519-21.
Primary aortoenteric fistula (PAEF) is a well-known but rare cause of gastrointestinal bleeding. The diagnosis can be difficult since the majority of patients do not have classical symptoms. "Herald bleed" is usually followed by a massive hemorrhage. Endoscopy and radiographic studies can assist in diagnosis. We present the case of 56-year-old male with PAEF who presented with obscure gastrointestinal bleeding. Endoscopic studies were unremarkable. Computed tomography (CT) in this stable but symptomatic patient helped in establishing diagnosis of PAEF. Patient underwent laparotomy with aortobifemoral graft placement. A high index of suspicion, early diagnosis and prompt appropriate surgical intervention are crucial for survival of these patients.
原发性主动脉肠瘘（PAEF）是一种已知但罕见的胃肠道出血原因。由于大多数患者没有典型症状，诊断可能会很困难。“前驱性出血”之后通常会发生大出血。内镜检查和影像学检查有助于诊断。我们报告一例56岁患有PAEF的男性患者，其表现为不明原因的胃肠道出血。内镜检查无异常发现。对于这位病情稳定但有症状的患者，计算机断层扫描（CT）有助于确诊PAEF。患者接受了剖腹手术并置入了主动脉双股动脉移植物。高度的怀疑指数、早期诊断和及时恰当的手术干预对于这些患者的存活至关重要。
