Jayarajan Senthil, Napolitano Lena M, Rectenwald John E, Upchurch Gilbert R
Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Vasc Endovascular Surg. 2009 Dec;43(6):592-6. doi: 10.1177/1538574409335275. Epub 2009 Jul 29.
Primary aortoenteric fistulae are difficult conditions to diagnose and manage. A 35-year-old male developed massive upper gastrointestinal hemorrhage due to a primary aortoduodenal fistula. Previous radiation therapy and retroperitoneal lymph node dissection for germ cell cancer with resultant dense retroperitoneal fibrosis made open aortic repair impossible. Endovascular balloon occlusion of the aorta and stent graft repair of the primary aortoduodenal fistula was performed. At 1-year follow-up, there is no clinical or radiographic evidence of stent-graft infection. Endovascular techniques and repair are important approaches to consider during the management of complicated primary aortoenteric fistulae when open surgical repair is not feasible.
原发性主动脉肠瘘是难以诊断和处理的病症。一名35岁男性因原发性主动脉十二指肠瘘出现大量上消化道出血。既往因生殖细胞癌接受放射治疗及腹膜后淋巴结清扫，导致致密的腹膜后纤维化，无法进行开放性主动脉修复。遂行主动脉内球囊闭塞及原发性主动脉十二指肠瘘的支架移植物修复术。随访1年时，无支架移植物感染的临床或影像学证据。当开放性手术修复不可行时，血管内技术和修复是处理复杂性原发性主动脉肠瘘时应考虑的重要方法。
