Perez Rodrigo O, Katayama Fabio F, Bresciani Cláudio, Jacob Carlos E, Coser Roger B, Alves Paulo R A, Habr-Gama Angelita, Gama-Rodrigues Joaquim J, Kiss Desidério R, Cimelli Mario
Colorectal Surgery Division, Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil.
Curr Surg. 2005 Jan-Feb;62(1):49-54. doi: 10.1016/j.cursur.2004.06.018.
Aortoenteric fistula is defined as a communication between the aorta and any adjacent segment of the bowel. It may be primary or secondary. The former occurs de novo in patients with intestinal or vascular diseases, whereas secondary aortoenteric fistula is a rare and dreadful complication of aortic reconstruction with vascular prosthesis. We report a case of a 62-year-old man who presented to the emergency department with acute rectal bleeding. The patient had previous aortoiliac surgery with the utilization of an aorto-bifemoral vascular graft. Diagnosis of secondary aortoenteric fistula was made between the aortoiliac graft and sigmoid colon. After exploratory laparotomy, Hartmann's procedure, excision of the graft, oversewing of the aortic stump, and axilobifemoral bypass were successfully performed. This study reports a rare type of secondary aortoenteric fistula to the left colon, and it describes an unusual and successful surgical treatment.
主动脉肠瘘被定义为主动脉与肠道任何相邻节段之间的连通。它可以是原发性的或继发性的。前者在患有肠道或血管疾病的患者中初发,而继发性主动脉肠瘘是使用血管假体进行主动脉重建的一种罕见且可怕的并发症。我们报告一例62岁男性患者,因急性直肠出血就诊于急诊科。该患者既往接受过主动脉髂动脉手术,使用了主动脉双股血管移植物。诊断为主动脉髂动脉移植物与乙状结肠之间的继发性主动脉肠瘘。经剖腹探查后,成功实施了哈特曼手术、移植物切除、主动脉残端缝合以及腋股动脉旁路移植术。本研究报告了一种罕见的左侧结肠继发性主动脉肠瘘类型,并描述了一种不同寻常且成功的手术治疗方法。