Barleben Andrew R, Baig Mirza S, Kubaska Stephen M, Fujitani Roy M, Gordon Ian A, Lane John S
University of California Irvine Medical Center, Orange, CA 92868, USA.
Ann Vasc Surg. 2007 Sep;21(5):629-32. doi: 10.1016/j.avsg.2007.01.011. Epub 2007 May 29.
Aortoenteric fistulae require urgent definitive intervention and traditionally carry a high mortality. We describe a patient who suffered a traumatic aortic dissection following an auto versus pedestrian collision. He underwent open fenestration of his infrarenal aorta and visceral resection, complicated by abdominal sepsis and enterocutaneous fistulae. One month later he developed massive hematemesis, and endoscopic examination revealed an aortoduodenal fistula. Due to an impassable abdominal wall, a stent-graft repair was performed. This report describes the successful use of endovascular techniques to achieve immediate hemostasis in an actively hemorrhaging aortoduodenal fistula. An endovascular approach provides a valuable option in settings where a hostile abdomen precludes the traditional open technique and may serve as a bridge to later definitive repair.
主动脉肠瘘需要紧急确定性干预，传统上死亡率很高。我们描述了一名在汽车与行人碰撞后发生创伤性主动脉夹层的患者。他接受了肾下腹主动脉开窗术和内脏切除术，并发腹部脓毒症和肠皮肤瘘。一个月后，他出现大量呕血，内镜检查发现主动脉十二指肠瘘。由于腹壁无法手术，遂进行了支架移植物修复。本报告描述了在活动性出血的主动脉十二指肠瘘中成功使用血管内技术实现即时止血的情况。在腹部情况复杂而无法采用传统开放技术的情况下，血管内方法提供了一个有价值的选择，并且可以作为后期确定性修复的桥梁。
