Heidemann J, Domagk D, Wessling J, Domschke W, Kucharzik T F
Department of Medicine B, University of Münster, Münster, Germany.
Z Gastroenterol. 2006 Sep;44(9):981-4. doi: 10.1055/s-2006-926740.
Aorto-enteric fistulas are rare but serious clinical conditions that may arise as a complication following abdominal aortic surgery. Clinical symptoms in affected patients range from obscure recurrent gastrointestinal bleeding and intermittent unexplained fever attacks to fulminant hematochezia and rapid exsanguination. A high degree of clinical alertness and suspicion is critical for both accurate diagnosis and timely surgical therapy in these patients. This case report describes a patient who was referred to our department six months after abdominal aortic surgery. The patient presented with septic illness and episodes of obscure gastrointestinal bleeding. Diagnostic work-up revealed a retroperitoneal infection of the aortic graft. A false aneurysm led to recurrent duodenal bleeding, which was accompanied by perforation of the obliterated aortic graft into the cecum. After immediate surgical repair, the patient recovered and continues to do well. We present a brief review of the current literature on this entity, outlining different surgical strategies and their outcomes.
主动脉肠瘘是一种罕见但严重的临床病症，可作为腹主动脉手术后的并发症出现。受影响患者的临床症状范围从隐匿性反复胃肠道出血和间歇性不明原因发热发作到暴发性便血和迅速失血。高度的临床警觉性和怀疑对于这些患者的准确诊断和及时手术治疗至关重要。本病例报告描述了一名在腹主动脉手术后六个月转诊至我科的患者。该患者表现为败血症和隐匿性胃肠道出血发作。诊断性检查发现主动脉移植物发生腹膜后感染。一个假性动脉瘤导致十二指肠反复出血，并伴有闭塞的主动脉移植物穿孔进入盲肠。经过立即手术修复，患者康复且情况持续良好。我们对关于该病症的当前文献进行简要综述，概述不同的手术策略及其结果。
