Ueno Masahiro, Iguro Yoshifumi, Nagata Toshiyuki, Sakata Ryuzo
Department of Cardiovascular Surgery, Kagoshima University Graduate School of Medicine, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Surg Today. 2006;36(6):546-8. doi: 10.1007/s00595-006-3186-9.
We report a case of an aortoenteric fistula (AEF) developing after endovascular stent grafting (EVSG) for an abdominal aortic aneurysm (AAA). A 69-year-old male patient with a history of panperitonitis caused by rectal perforation underwent EVSG for an AAA. A follow-up contrast-enhanced computed tomography (CT) scan, done 12 months after the EVSG, confirmed shrinkage of the AAA with no endoleak. However, 19 months postoperatively, an AEF developed between the AAA and the jejunum. Although there was no endoleak on a subsequent CT scan, we noted enlargement of the AAA and inflammatory changes in the surrounding tissue. The patient was treated surgically and discharged in good health 74 days postoperatively. Thus, one should consider the possibility of this devastating complication, even in patients without an endoleak, after EVSG for AAA.
我们报告了1例腹主动脉瘤（AAA）行血管内支架植入术（EVSG）后发生主动脉肠瘘（AEF）的病例。一名69岁男性患者，有因直肠穿孔导致的全腹膜炎病史，因AAA接受了EVSG。EVSG术后12个月进行的随访增强计算机断层扫描（CT）显示AAA缩小且无内漏。然而，术后19个月，AAA与空肠之间发生了AEF。尽管随后的CT扫描未发现内漏，但我们注意到AAA增大且周围组织有炎症改变。患者接受了手术治疗，术后74天健康出院。因此，即使在没有内漏的患者中，对于AAA行EVSG后也应考虑这种严重并发症的可能性。
